Presents characteristics contributing to the formation of
four accountable care organizations (ACOs) that serve
rural Medicare beneficiaries, one each of the four census
regions (West, Midwest, Northeast, and South).
Semi-structured interviews were conducted on-site with
ACO leaders and representatives of key stakeholder groups
(e.g., board members, physicians, information technology
managers). Four organizational characteristics emerged as
influential in the formation of these ACOs. First is
previous organizational integration experience, which
includes physician-hospital organizations, independent
practice associations and mergers. Second is experience
in risk-sharing arrangements, which includes
participation in the Medicare Advantage program and
insurance plan ownership. Third are information
technologies, especially shared electronic health
records, which enable several ACO capabilities. And
fourth is developing partnerships with health and human
services organizations in local and regional communities.
These findings can help rural providers interested in
forming or participating in an ACO assess the status and
potential gaps of their core structures and capabilities.