Accountable care organizations (ACOs) were created to coordinate care services with the ultimate goal of delivering high-quality care while reducing costsPreliminary studies on ACOs’ results have shown modest declines in spending for patients and hospitals, but a recent study in the Journal of Clinical Oncology (JCO) found those results may not persist over the long term, at least not in cancer care.

Miranda Lam, a radiation oncologist at Dana-Farber Cancer Institute, and her colleagues compared Medicare claims data from 2011 to 2015 for beneficiaries with a cancer diagnosis at ACO practices with non-ACO practices in the same geographic region. The authors found that the introduction of ACOs had no meaningful effect on spending or utilization for patients diagnosed with 11 different types of cancer.

Why It Matters: The new findings on the inability of ACOs to impact spending for costly diseases illustrate the danger of assuming one cost-saving approach will automatically work across all conditions. Looking hard at possible reasons for a lack of cost savings—the authors of the JCO piece indicate that the difficulty in treating complex diseases, as well as a drive toward value-based care, is impacting ACOs and non-ACOs in similar ways—will be critical in fashioning future care models that can deliver high-quality care for less money.