The Accountable Care Organization (ACO) was promoted by the Affordable Care Act as one way to address the spiraling cost increases and disappointing quality outcomes that had characterized U.S. healthcare to date.  The bill offered financial incentives to encourage adoption of the ACO format, and appears to have been successful in that regard – hundreds of ACOs have formed.

The bigger question is whether ACOs really are an effective mechanism for holding providers accountable for containing costs and improving quality, and whether, in fact, they are even necessary.