The Impact of Accountable Care: Physician Participation in Accountable Care Organizations

Accountable Care Organizations (ACOs) consist of groups of health care providers who accept responsibility for the financial and quality outcomes for a defined population. Physician involvement is essential in achieving an ACO’s goal of improving outcomes while lowering costs.

The Issue

Accountable care emphasizes team-based care. Physicians play an important role in helping the ACO meet its goals within this model. As ACOs accept responsibility for financial and quality outcomes for a defined population, physicians will find new opportunities and challenges.

Key Findings

  • Accountable care impacts the practice of medicine, including care coordination, prevention and disease management, care protocols, cost-conscious decision-making, expanded access, and technology.

  • There are many roles within an ACO for a physician, including roles in physician groups, leadership roles at the administrative or care team levels, and roles as primary care physicians and specialists.

  • A physician’s compensation can be positively or negatively impacted by ACO participation. This impact largely depends on factors like physician employment arrangement, ACO performance, and the specific method for distributing shared savings or other bonus payments.


Physicians have an opportunity to refocus their work and assume new leadership roles within the ACO delivery model. Data analytics, care coordination, management, and leadership are areas of opportunity for physicians to learn and contribute to a successful ACO.

About the Grantee

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.