Based on interviews with clinical and administrative leaders, this report describes the
experiences of seven accountable care organizations (ACOs). Despite gaps in readiness
and infrastructure, most of the ACOs are moving ahead with risk-based contracts, under
which the ACO shares in savings achieved; a few are beginning to accept “downside risk” as
well. Recruiting physicians and changing health care delivery are critical to the success of
ACOs—and represent the most difficult challenges. ACO leaders are relying on physicians …