Physician Practice Participation in Accountable Care Organizations: The Emergence of the Unicorn

Objective To provide the first nationally based information on physician practice involvement in ACO s. Data Sources/Study Setting Primary data from the third National Survey of Physician Organizations (January 2012–May 2013). Study Design We conducted a 40‐minute phone survey in a sample of physician practices. A nationally representative sample of practices was surveyed in order to provide estimates of organizational characteristics, care management processes, ACO participation, and related variables for four major chronic illnesses. Data Collection/Extraction Methods We evaluated the associations between ACO participation, organizational characteristics, and a 25‐point index of patient‐centered medical home processes. Principal Findings We found that 23.7 percent of physician practices ( n = 280) reported joining an ACO ; 15.7 percent ( n = 186) were planning to become involved within the next 12 months and 60.6 percent ( n = 717) reported no involvement and no plans to become involved. Larger practices, those receiving patients from an IPA and/or PHO , those that were physician‐owned versus hospital/health system‐owned, those located in New England, and those with greater patient‐centered medical home ( PCMH ) care management processes were more likely to have joined an ACO . Conclusions Physician practices that are currently participating in ACO s appear to be relatively large, or to be members of an IPA or PHO , are less likely to be hospital‐owned and are more likely to use more care management processes than nonparticipating practices.