Supplemental Online Materials. This Appendix includes additional information provided by the authors, including the full PubMed search, the data abstraction form, and the list of articles reviewed.
Full PubMed Search
"Accountable Care Organizations"[Mesh] OR [("accountable care organization"[All Fields] OR "accountable care organizations"[All Fields] OR "accountable care"[All Fields] OR "ACO"[All Fields] OR "ACOs"[All Fields]) AND English[lang] AND "2006/01/01"[PDAT] : "3000"[PDAT] NOT "animals"[MeSH Terms:noexp] NOT "ACO(-)"[All Fields] NOT "Acute Coronary Syndromes Registry"[All Fields] NOT "ACOS registry"[All Fields]]
Final Data Abstraction Form
Article Identifier (PMID or title) ______
1. Article Type Circle only 1:
news report or “primer” on ACOs
position statement
empirical study (including case studies)
review
editorial/commentary
letter
personal narrative
interview
regulations / commentary on regulations
Other ______
2. Does the article reference specific stakeholders? YES or NO
If YES, who (may choose >1)? Clinicians (doctors, nurses, others)
Administrators (incl. hospitals)
Patients
Policymaker / politicians
If administration, specific group(s)? Hospital administration
Practice administration
Insurer administration
Other ______
If patients, specific group(s)? Elderly
Disabled
Oncology patients
Racial/ethnic minority
ESRD
Other ______
If “Clinicians,” (sub)specialties? Family Practice
General Pediatrics
General Internal Medicine
Nurse practitioners
Clinical Nurse Specialist
Physician Assistant
OB/GYN
Cardiology
Gastroenterology
Oncology
General Surgery
Surgical subspecialty
Radiology
Nursing
Community Health Workers
Home health care
Other______
3. Does the article use “ethic(s), ethical, moral, morality, professional(ism)” with respect to values and standards? YES or NO
If YES:
Where? (may circle more than one) Title Abstract Text
If YES:
Term(s) (may circle more than one) ethic(s)
ethical
moral
morality
professional
professionalism
If YES
Number of (total) occurrences ______
4. What themes are identified in this article?
Choose one or more themes. If not mentioned, leave blank or check N/A. By “tone of article,” evaluate whether the article considers ACOs to positively or negatively affect that theme. For example, if an article claims that ACOs will not improve health care costs, that would be a negative tone. If an article claims ACOs will improve patient choice, that would be a positive tone.
Themes / Tone of Article Toward ThemeN/A / Positive / Negative / Mixed
Appropriate Leadership of ACOs (“who should”)
Dual responsibility of providers, incl. conflict of interest
Informed consent in ACOs
Patient autonomy/choice
Patient confidentiality
Health care spending/cost
Practice financial viability (including financial risk to practice)
Financial competition between specialties
Quality of patient care, including patient-centered care
Care coordination and/or integration
Patient safety (incl. reducing harms and errors)
Access to care
Health disparities
Distribution of resources
How ACOs affect specific (sub)specialties or disciplines
Describes regulations or “How to” guide
Case study to inform ACO development
FTC regulations and health care integration (anti-trust)
Health information exchanges or information technology
Incentives
Physician Autonomy
Other:
NOTE: This list of originally hypothesized themes does not include those added during our review: patient accountability (i.e., patients’ proper role in the ACO); patient engagement; competitive tension between physicians and hospitals; the role of academic medical centers (AMCs) as appropriate leaders of ACOs; the imperative of team communication in achieving ACOs’ goals; whether ACOs’ mission should be to improve public health generally; appropriate performance measurement; and leaders’ “cofiduciary” obligations
5. Was one of these themes “Primary” for this article?
Circle YES / NO
If YES, please circle the theme in the above table.
If YES, how did you identify it? You can circle more than 1. Title Abstract Text
List of 300 articles included in the content analysis.
/ List of Articles Reviewed // PMID / First Author / Other Authors / Title / Journal / Volume / Issue / Pages / Date of Publication /
1 / 22413631 / Zimmer LL / None / The ABCs of ACOs / WMJ / 110 / 4 / 205-6 / 08/01/2011
2 / 22413588 / Reiboldt M / None / Will the FTC kill ACOs and clinical integration? / J Med Pract Manage / 27 / 4 / 187-8 / 01/01/2012
3 / 22411546 / Marmor T / Oberlander J / From HMOs to ACOs: The Quest for the Holy Grail in U.S. Health Policy / J Gen Intern Med / Epub / Epub / Epub / 03/13/2012
4 / 22389936 / Weil TP / None / Accountable care organizations: HMOs by another name? / J Fam Pract / 61 / 1 / 10 / 01/01/2012
5 / 22381550 / Schoenrock S / None / Nursing involvement in accountable care organizations / AORN J / 95 / 3 / 321 / 03/01/2012
6 / 22360110 / Swan BA / Haas SA / Health care reform: current updates and future initiatives for ambulatory care / Nurs Econ / 29 / 6 / 331-4 / 11/01/2011
7 / 22355927 / Robeznieks A / None / Hopeful over future of ACOs / Mod Healthc / 42 / 1 / 26-7 / 01/01/2012
8 / 22352173 / Khan F / None / A closer look at ACOs. Patients and quality care come first / Health Manag Technol / 33 / 1 / 20 / 01/01/2012
9 / 22351970 / Rein A / Kennedy H, DeCoudrews B, Singer Cohen R, Sabharwal R, Fairbrother G / Evaluation design and technical assistance opportunities: early findings from the Beacon Community Program evaluation teams / Issue Brief (Commonw Fund) / 1 / 1-22 / 01/01/2012
10 / 22346311 / Barlas S / None / Final Rule on ACOs Raises Concerns About Medication Cost-Shifting: Pharmacists to
Play a Secondary Role in New Physician-Hospital Organizations / P T / 36 / 12 / 780 / 12/01/2011
11 / 22346301 / Barlas S / None / Pharmacists Want a More Explicit Role in ACOs: Medicare's Hands Are Tied ... at
Least Initially / P T / 36 / 10 / 685-7 / 10/01/2011
12 / 22338964 / Pinzur M / None / FootForum: ACOs and the future of healthcare / Foot Ankle Int / 32 / 11 / 1101 / 11/01/2011
13 / 22338835 / No authors listed / None / Health Care IT: staying on top of the game / Hosp Health Netw / 86 / 1 / 47-57 / 01/01/2012
14 / 22338832 / Terry K / None / Why are health plans buying physician groups? / Hosp Health Netw / 86 / 1 / 30-2, 41, 1 / 01/01/2012
15 / 22338831 / Umbdenstock R / None / The new era of accountability. Interview by Haydn Bush. / Hosp Health Netw / 86 / 1 / 28-9 / 01/01/2012
16 / 22333926 / Sussman I / Prystowsky MB / Pathology service line: a model for accountable care organizations at an academic
medical center / Hum Pathol / 43 / 5 / 629-31 / 05/01/2012
17 / 22324197 / Dahl O / None / Now you know your ACOs / MGMA Connex / 11 / 10 / 45-6 / 11/01/2011
18 / 22308876 / Bachman SS / None / Accountable care organizations: opportunities for social workers / Health Soc Work / 36 / 4 / 245-7 / 11/01/2011
19 / 22308596 / Summers L / None / ANA to comment on new rules on accountable care organizations / Nebr Nurse / 44 / 4 / 9 / 12/01/2011
20 / 22303775 / Mullikin LE / None / Kathleen Mears Memorial Lecture: Are we ready for 2014? An overview of healthcare
reform for the neurodiagnostic practitioner / Am J Electroneurodiagnostic Technol / 51 / 4 / 229-46 / 12/01/2011
21 / 22296074 / Stine NW / Chokshi DA / Opportunity in austerity--a common agenda for medicine and public health / N Engl J Med / 366 / 5 / 395-7 / 02/02/2012
22 / 22296073 / Landon BE / None / Keeping score under a global payment system / N Engl J Med / 366 / 5 / 393-5 / 02/02/2012
23 / 22277862 / Hart MA / None / Accountable care organizations: the future of care delivery? / Am J Nurs / 112 / 2 / 23-6 / 02/01/2012
24 / 22274681 / Emanuel EJ / Pearson SD / Physician autonomy and health care reform / JAMA / 307 / 4 / 367-8 / 01/25/2012
25 / 22269459 / Worsowicz G / None / Update on accountable care organizations / PM R / 4 / 1 / 84 / 01/01/2012
26 / 22259931 / Ganske I / Abbott MM, Meara J / Accountable care organizations: a primer for surgeons / Bull Am Coll Surg / 96 / 9 / 27-35 / 09/01/2011
27 / 22235668 / Kocher R / Sahni NR / Physicians versus hospitals as leaders of accountable care organizations / Md Med / 12 / 3 / 21-2 / 01/01/2011
28 / 22235659 / Ajrawat HS / None / Are ACOs the magic bullet? / Md Med / 12 / 3 / 4 / 01/01/2011
29 / 22235488 / Hagland M / None / Ready to catch the next wave? The new acccountability agenda in healthcare / Healthc Inform / 28 / 12 / 8-16 / 12/01/2011
30 / 22233018 / Delbanco SF / None / ACOs: challenges and opportunities. Interviewed by Mark Hagland / Healthc Inform / 28 / 12 / 40-1, 44 / 12/01/2011
31 / 22232108 / Peek ME / Roberson TS, Goddu AP, Nocon RS, Tang H, Quinn MT, Bordenave KK, Huang ES, Chin MH / Early lessons from an initiative on Chicago's South Side to reduce disparities in diabetes care and outcomes / Health Aff (Millwood) / 31 / 1 / 177-86 / 01/01/2012
32 / 22224884 / Luft HS / None / From small area variations to accountable care organizations: how health services research can inform policy / Annu Rev Public Health / 33 / 377-92 / 04/01/2012
33 / 22215163 / Skinner JS / Weinstein JN, Fisher ES / Withholds to slow Medicare spending: a better deal than cuts / JAMA / 307 / 1 / 43-4 / 01/04/2012
34 / 22204720 / Fisher ES / McClellan MB, Safran DG / Building the path to accountable care / N Engl J Med / 365 / 26 / 2445-7 / 12/29/2011
35 / 22204674 / Walker J / McKethan A / Achieving accountable care--"It's not about the bike". / N Engl J Med / 366 / 2 / e4 / 12/28/2011
36 / 22195436 / Riney S / None / Other voices. Worth the risk? Hospital aims to prove that quality care pays / Hosp Health Netw / 85 / 11 / 12,14 / 11/01/2011
37 / 22195413 / Norman G / Schulte D / How collaborative care platforms can make ACOs a reality for all physicians / Physician Exec / 37 / 6 / 24-8 / 11/01/2011
38 / 22175212 / Evans M / None / Model support: NCQA offers standards, designations for Acos. / Mod Healthc / 41 / 47 / 16 / 11/21/2011
39 / 22160067 / Johnson KA / Zhou ZY / Costs of care in hemophilia and possible implications of health care reform / Hematology Am Soc Hematol Educ Program. / 2011 / 413-8 / 01/01/2011
40 / 22146637 / Meek JA / None / Affordable Care Act: predictive modeling challenges and opportunities for case management / Prof Case Manag / 17 / 1 / 15-21 / 01/01/2012
41 / 22142879 / Erler A / Bodenheimer T, Baker R, Goodwin N, Spreeuwenberg C, Vrijhoef HJ, Nolte E, Gerlach FM / Preparing primary care for the future - perspectives from the Netherlands, England, and USA. / Z Evid Fortbild Qual Gesundhwes / 105 / 8 / 571-80 / 10/21/2011
42 / 22130266 / Shomaker TS / None / AM last page: Accountable care organizations (ACOs) / Aacd Med / 86 / 12 / 1598 / 12/01/2011
43 / 22128506 / Marsh HM / Schenk MJ / Primary care in the new millennium: affordable, sustainable systems of care / Mich Med / 110 / 5 / 8 / 09/01/2011
44 / 22123918 / Roehr B / None / Head of Medicare and Medicaid steps down after just 18 months / BMJ / 343 / d7714 / 11/28/2011
45 / 22114154 / McCullough LB / None / An ethical framework for the responsible leadership of accountable care organizations / Am J Med Qual / 27 / 3 / 189-94 / 11/23/2011
46 / 22108233 / Melvin JL / Worsowicz G / What are the implications of accountable care organizations for physical medicine and rehabilitation practices? / PM R / 3 / 11 / 1068-71 / 11/01/2011
47 / 22099715 / Allen JI / None / Gastroenterologists and the triple aim: how to become accountable / Gastrointest Endosc Clin N Am. / 22 / 1 / 85-96 / 10/20/2011
48 / 22089404 / Carrol VS / None / Reimagining nursing quality in the accountable care landscape / J Neurosci Nurs / 43 / 6 / 285 / 12/01/2011
49 / 22085985 / Rokos IC / None / Creating "turbo" accountable care organizations for time-critical diagnoses / Circ Cardiovasc Qual Outcomes / 4 / 6 / 647-9 / 11/01/2011
50 / 22082415 / Rozensky RH / None / The institution of the institutional practice of psychology: health care reform and psychology's future workforce / Am Psychol / 66 / 8 / 797-808 / 11/01/2011
51 / 22076715 / Morrow CE / Reed VA, Eliassen MS, Imset I / Shared decision making: skill acquisition for year III medical students / Fam Med / 43 / 10 / 721-5 / 11/01/2011
52 / 22073511 / Mirvis DM / None / Accountable care organizations: a real change, maybe / Tenn Med / 104 / 9 / 29-32 / 10/01/2011
53 / 22062938 / Kisloff B / None / Accountable care organizations / Clin Gastroenterol Hepatol / 10 / 4 / 442 / 11/04/2011
54 / 22053645 / Reynolds J / Roble D / The financial implications of ACOs for providers. / Healthc Financ Manage / 65 / 10 / 76-82 / 10/01/2011
55 / 22046633 / Centers for Medicare & Medicaid Services (CMS), HHS / None / Medicare program; Medicare Shared Savings Program: Accountable Care Organizations. Final rule / Fed Regist / 76 / 212 / 67802-990 / 11/02/2011
56 / 22046632 / Centers for Medicare & Medicaid Services (CMS) and Office of Inspector General, HHS / None / Medicare program; final waivers in connection with the Shared Savings Program. Interim final rule with comment period / Fed Regist / 76 / 212 / 67992-8010 / 11/02/2011
57 / 22046619 / Hagland M / None / Many mountains to climb / Healthc Inform / 28 / 10 / 10-5 / 10/01/2011