Primary Care


United Hospital Fund

Funding Area

Primary Care


April 9, 2015


This United Hospital Fund (UHF) report, supported by NYHealth, outlines the early experiences of New York Medicare accountable care organizations (ACOs), with attention to the implications of sponsorship type and previous investment in necessary infrastructure.

ACOs aim to transform the way health care is delivered and have the potential to improve patient care and reduce costs. In New York, 27 provider groups are now participating in Medicare’s Pioneer ACO program or in the Medicaid shared savings program. UHF interviewed 17 leaders of these organizations for their experiences and insights to date.

This qualitative report examines differences in the sponsorship of New York’s ACOs, noting that group practices and hospital systems appear to be more advantageously positioned for accountable care than less formally organized physician networks and physician-hospital partnerships, in part because they are more likely to have unified leadership, well-developed infrastructure (including the same electronic medical record systems), and a common culture.

An accompanying quantitative report, “New York’s Medicare ACOs: Participants and Performance,” examines the growth of accountable care across the State and explores regional variation. It also summarizes financial results of New York’s 16 earliest ACOs in their first performance year.