Among practitioners and proponents, the accountable care organization (ACO) model is usually characterized as a disruptive innovation in US health care that reflects over two decades of calls for quality-based payments within Medicare. Some academic analyses are more circumspect (Burns and Pauly 2012) and question whether they differ substantially enough to overcome some of the issues observed when other policy innovations were introduced. In this special issue, Robert Berenson (2015), Roger Feldman (2015), Eric Kessell et al. (2015), and Lawrence P. Casalino et al. (2015), respectively, highlight pricing, cost bases, quality, and population health components of this new model. Their articles point to ACOs as conforming to long-standing patterns in US health policy: overconfidence in the level of policy disruption occurring and, relatedly, underestimation of the potential for strategic adaptation by providers. Those...

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