Which are features of ACOs?

• A. One-sided and Two-sided risk
• B. Access to capital upfront
• C. Percentage of risk/earnings sharing
• D. All of the above

Answer: (D)

ACOs combine care coordination with financial incentives to improve quality while reducing costs. They can operate with either one-sided risk, where providers share in savings but don’t incur losses, or two-sided risk, where they share both savings and losses if spending exceeds targets. The agreements also specify how large the share of any savings (or losses) will be that goes to the ACO, establishing a clear percentage framework for earnings sharing. Additionally, many ACO arrangements involve upfront capital to build the necessary infrastructure—such as health IT, data analytics capabilities, and care-management staff—to support population health management. Because these features—risk arrangements, earnings/risk sharing, and upfront capital—commonly appear together in ACO models, choosing all of the above reflects the typical structure.