Table 2

ACOs’ relationship with public health agencies

Possible scenarios for ACOs’ relationship with public health agencies
1ACOs focus mainly on their own patients, with limited contact with public health agencies
2Spillover effects from ACOs’ community benefit programmes bring them into relationship with public health agencies, for example, health education lectures attended by people who are not currently patients, or sporadic health fairs
3Formal partnership with public health agencies is established to deliver interventions only for the ACO patients, for example, referrals of ACO patients to services run by the public health agency
4Formal partnership with public health agencies lead to development of a joint strategic plan for interventions for the population of the whole geographical area, for example, a county-wide smoking cessation programme in ACOs, other healthcare establishments, schools, community centres and other locations (with the potential for one shared budget, management and resources)
5Formal partnership with public health agencies with financial savings due to improved health outcomes being divided among partners, for example, savings from the ACO and the government public health department being reinvested into jointly managed geographically based health improvement interventions21 22
  • ACO, accountable care organisation.