AJMC July 9, 2025
Mariétou H. Ouayogodé, PhD, Xiaodan Liang, MS, David B. Muhlestein, PhD, JD

Accountable care organization (ACO) participation was associated with an increase in hospitals’ mean market share and with additional market share gains in more concentrated markets.

ABSTRACT

Objectives: To assess trends in market share (MS) over time among hospitals participating in Medicare accountable care organizations (ACOs) and non-ACO participants, and evaluate correlates of differences.

Study Design: Longitudinal study of US hospital and ACO data for 3534 short-term acute care hospitals ever participating in Medicare ACOs or not across hospital referral regions (HRRs) from Milliman Torch Insight (2011-2020).

Methods: Using HRR as the local market, we calculated 3 hospital MS measures using annual net patient revenue, discharges, and beds, and we calculated market concentration using a modified Herfindahl-Hirschman Index. We compared hospital...

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Topics: ACO (Accountable Care), Health System / Hospital, Payment Models, Provider, Survey / Study, Trends, Value Based
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