Harvard Health Letter

Accountable care organizations

American health care needs to be cured of its high-spending, disorganized ways. Are accountable care organizations the right medicine?

Health maintenance organizations (HMOs) and managed care were supposed to mend much of what ails American health care: the relentless rise in spending, care that's disjointed and uncoordinated, the disregard of prevention relative to the bills paid for treatment.

They weren't total flops. Some, not all, of the surviving HMOs get good grades on quality-of-care report cards. The managed-care push of the 1990s did stabilize health care spending for much of that decade. But the success was definitely limited, and cost and disorganization continue to plague American health care.

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