This report synthesizes findings and lessons from case studies of four diverse health care organizations participating in the Brookings–Dartmouth ACO Pilot Program, launched in 2009 to support selected provider groups that are collaborating with private payers to form accountable care organizations (ACOs). The organizations are: HealthCare Partners, a medical group/independent practice association (IPA) in Los Angeles, Calif.; Monarch HealthCare, an IPA in Orange County, Calif.; Norton Healthcare, an integrated delivery system in Louisville, Ky.; and Tucson Medical Center, a community hospital working with independent provider groups in Tucson, Ariz.
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This study was based on publicly available information and self-reported data provided by the case study institution(s). The aim of Commonwealth Fund–sponsored case studies of this type is to identify institutions that have achieved results indicating high performance in a particular area of interest, have undertaken innovations designed to reach higher performance, or exemplify attributes that can foster high performance. The studies are intended to enable other institutions to draw lessons from the studied institutions' experience that will be helpful in their own efforts to become high performers. Even the best-performing organizations may fall short in some areas or make mistakes—emphasizing the need for systematic approaches to improve quality and prevent harm to patients and staff. The Commonwealth Fund is not an accreditor of health care organizations or systems, and the inclusion of an institution in the Fund's case study series is not an endorsement by the Fund for receipt of health care from the institution.