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Health Aff (Millwood). 2012 Aug;31(8):1777-85. doi: 10.1377/hlthaff.2012.0490.

The promise and peril of accountable care for vulnerable populations: a framework for overcoming obstacles.

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Center for Population Health, Dartmouth Institute for Health Policy and Clinical Practice in Lebanon, New Hampshire, USA.


Accountable care organizations (ACOs) are a promising payment model aimed at reducing costs while also improving the quality of care. However, there is a risk that vulnerable populations may not be fully incorporated into this new model. We define two distinct vulnerable populations, clinically at-risk and socially disadvantaged, and we discuss how ACOs may benefit each group. We provide a framework to use in considering challenges for both vulnerable patients and health systems on the path to accountable care. We identify policies that can help overcome these obstacles: strategies that support ACO formation in diverse settings and that monitor, measure, and reward the performance of providers that reach all patients, including vulnerable populations.

[Indexed for MEDLINE]

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