The Impact of Accountable Care: Employer Perspectives on Accountable Care

Employers are beginning to show strong interest in ACOs that improve quality and control the cost of health care for their employees.

The Issue

Accountable care organizations (ACO) place responsibility of quality and costs on a provider group for a defined population with the aim of reducing costs. Most ACOs today are hospital or physician group-based and provide care across settings. They have a strong information technology infrastructure and encourage providers to manage financial risk. Through employee benefit design, employers can encourage employees to sign up with ACOs.

Key Findings

Among employer concerns regarding ACOs:

  • Employers are reticent to invest resources in an unproven model that may not yield results for several years.

  • In order to improve care coordination and population health, ACOs need to share data across settings, something that requires a strong—and often costly—data infrastructure.

  • Any improved costs and health outcomes realized from ACOs should also benefit employers and not be added as fees or translated into higher prices for services if providers consolidate.


These authors urge employers to become involved in ACOs by offering employees financial incentives to choose a primary care physician that participates in an ACO and by educating employees on how to become better health care consumers and active participants in their health care.

About the Study

This issue brief, one of six in a series called “The Impact of Accountable Care,” was prepared by the National Business Group on Health and Leavitt Partners with RWJF support. In 2015, National Business Group on Health surveyed large employers (average 55,000 U.S. employees each) for their reactions to ACOs.