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Six types of ACO’s

A new report released by Leavitt Partners, a healthcare intelligence firm, has identified six types of ACOs based on their organizational structure, ownership and patient care focus. To make ACOs more identifiable, Leavitt Partners wanted to use the taxonomy project to develop classifications for ACOs that are similarly structured and have similar opportunities to provide patient care in the same format             

Six types of ACO’s

1. Full Spectrum Integrated. These ACOs directly provide all aspects of healthcare to their patients. ACOs in this classification are often dominated by a large integrated delivery network.

2. Independent Physician Group. These ACOs have a single physician group owner and do not contract with other providers to offer additional services.

3. Physician Group Alliance. These ACOs may have multiple physician group owners — often including multi-specialty groups — but do not contract with other providers to offer additional services.

4. Expanded Physician Group. These ACOs only directly provide outpatient services (a patient who is not hospitalized overnight but who visits a hospital, clinic, or associated facility for diagnosis or treatment), but will contract with other providers to offer hospital or sub specialty services.

5. Independent Hospital. These ACOs have a single owner that directly provides inpatient services (a patient who is admitted to a hospital or clinic for treatment that requires at least one overnight stay) but do not provide sub-specialty care. In the case of integrated health systems, outpatient services are also provided.

6. Hospital Alliance. These ACOs have multiple owners with at least one of those owners directly providing inpatient services.

Although the ACOs in each group have many commonalities, these types are not definitive.ACOs can benefit from the classification of group types because many ACOs have a lot of good ideas, but they do not know what is going to work. The classifications will allow ACOs to identify the failures and success of like organizations.The researchers used information from more than 40 surveys and more than 100 interviews with ACO leaders as well as a database of 627 ACOs to analyze characteristics of ACOs and develop the classifications.

Because some physician organizations are more integrated than others (e.g., an Integrated Health System compared to a typical Independent Practice Association) they may have earlier success at becoming an ACO. Figure represents each type of physician organization on a relative scale of their current degree of integration, which may indicate the ease with which they could transition to an ACO.