Volume 53 | Number 4 | August 2018

Abstract List

Leeann N. Comfort M.P.P., Stephen M. Shortell Ph.D., M.P.H., M.B.A., Hector P. Rodriguez Ph.D., M.P.H., Carrie H. Colla Ph.D.


To examine whether an empirically derived taxonomy of Accountable Care Organizations (s) is associated with quality and spending performance among patients of s in the Medicare Shared Savings Program ().

Data Sources

Three waves of the National Survey of s and corresponding publicly available Centers for Medicare & Medicaid Services performance data for respondents participating in the (= 204); &A Office Based Physicians Database from Quintiles.

Study Design

We compare the performance of three types (physician‐led, integrated, and hybrid) for three domains: quality, spending, and likelihood of achieving savings. Sources of performance variation within and between types are compared for each performance measure.

Principal Findings

There is greater heterogeneity within types than between types. There were no consistent differences in quality by type, nor were there differences in likelihood of achieving savings or overall spending per‐person‐year. There was evidence for higher spending on physician services for physician‐led s.


s of diverse structures perform comparably on core quality and spending measures. should maintain its flexibility and continue to support participation of diverse s. Future research to identify modifiable organizational factors that account for performance variation within types may provide insight as to how best to improve performance based on organizational structure and ownership.