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Launching Accountable Care Organizations — The Proposed Rule for the Medicare Shared Savings Program

  • Donald M. Berwick, M.D., M.P.P.

This article has no abstract; the first 100 words appear below.

A common criticism of U.S. health care is the fragmented nature of its payment and delivery systems. Because in many settings no single group of participants — physicians, hospitals, public or private payers, or employers — takes full responsibility for guiding the health of a patient or community, care is distributed across many sites, and integration among them may be deficient. Fragmentation leads to waste and duplication — and unnecessarily high costs.Section 3022 of the Affordable Care Act (ACA) establishes the Medicare Shared Savings Program for accountable care organizations (ACOs) as a potential solution.1 The creation of ACOs is . . .

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Funding and Disclosures

Disclosure forms provided by the author are available with the full text of this article at

This article (10.1056/NEJMp1103602) was published on March 31, 2011, at

Author Affiliations

Dr. Berwick is the administrator of the Centers for Medicare and Medicaid Services, Baltimore.

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