ACO Toolkit

ACO Toolkit: A Roadmap for Employers ACO Logo

Please click on the circles below to access related ACO resources.

What is an ACO?
Is an ACO strategy right for my company?
Which ACOs are ready?
What are my network and plan design options?
How do I engage employees and align incentives?
How do I implement and evaluate an ACO?

ACOs Explained

What is an ACO? This two-page primer gives you the basics on what an ACO is, how it differs from past network strategies, it’s impact on employers already, and prospects for cost reduction and quality improvement going forward.

Employer Perspectives On Accountable Care: Definitions, Key Considerations, and Recommendations

This issue brief lays out definitions of ACOs, key questions employers should consider when looking at investing in an ACO strategy, and an overview of employer perspectives and concerns related to ACOs. This publication was created in collaboration with Leavitt Partners and the Robert Wood Johnson Foundation.

Summary of Health Care Provider Payment Reform Models

This document provides an overview of six provider payment reforms, including non-payment for adverse outcomes, pay-for-performance, accountable care organizations (ACOs), bundled payments, capitated payments, and reference-based pricing.

Employers' Current Strategy Around ACOs: Numbers You Need

Survey data outlining large employers' plans for contracting with ACOs in 2018 and beyond.

Employer Checklist on Questions for ACO Consideration

A list of questions to help employers assess whether an ACO strategy is right for their company

Interview and Transcript: Brian Marcotte Gives Recommendations for Employers Considering ACOs

Blog Post: Is an ACO Right for Your Company?

ACO Journey Map and ACO Journey Map Scoring Guide

The ACO Journey Map is a tool to help employers assess an accountable care organization’s (ACO) competencies along a maturity path. It provides employers with a framework to prompt conversations with health plans and ACO providers, and to inform decision-making about an ACO strategy.

The ACO Journey Map Scoring Guide contains instructions and detailed definitions of each competency in the ACO Journey Map.

ACO Journey Map – Interactive Fields

This version of the ACO Journey Map enables users to save data entered into the form. Please refer to the ACO Journey Map Scoring Guide for complete instructions.

ACO Performance Considerations Guide

The ACO Performance Considerations Guide is a tool to help employers better understand an ACO’s performance. It should be used in combination with the ACO Journey Map, performance measures found in the ACO contract, and any additional analysis available from the health plan and ACO providers.

Reaching a Tipping Point: Key Elements Necessary for ACO Success

This infographic contains data and information to help employers assess which ACOs are market-ready.

The ABCs of ACOs: Tools to Help Employers Get Started

This webinar provided an overview of ACOs including current market penetration and early results; a tutorial for using the Business Group's ACO Journey Map; and additional Business Group resources currently available to help employers build their own approach to implementing an ACO strategy. Aired August 9, 2017.

Blog Post: How to Choose and ACO: Tools for Employers

Eight Employer Plan Design and Engagement Strategies for High-Performing ACOs

This fact sheet explores why an employer may want to use financial and communication levers to steer employees to ACO providers, and several potential implementation strategies.

Employer Plan Design and Network Strategies for ACO Engagement

This webinar featured CVS Health’s vice president of benefits sharing their strategy for implementing two ACO pilots with Aetna. Learn how they redesigned their benefits to promote employee engagement within these ACOs. Aired October 13, 2017

ACO Physician-Patient Selection and Attribution

How patients are assigned to ACO providers can have a significant impact on the ACO’s ability to improve health and reduce costs. Self-insured employers must decide if and how they want to facilitate or require this assignment, commonly referred to as "patient attribution." This resource outlines several strategies for patient attribution employers should consider. 

8 Tips for Communicating with Employees about ACOs, PCMHs and Other Delivery System Changes

Employers, by using effective communication strategies, are well-positioned to educate and motivate their employee members to take advantage of delivery system improvements, and also direct them to more efficient health care providers. This Employer Guide provides recommendations for communicating payment and delivery reforms to employees.

ACOs Driving a Better Health Care Experience: New Innovations and Promising Practices

This webinar shares specific ways ACOs deliver a better patient experience than standard health care delivery models. Aired November 7, 2017.

Selecting and Contracting with Accountable Care Organizations: Boeing’s Perspective

On this webinar, The Boeing Company shares insights on key considerations for employers when deciding to partner with an ACO.


An accountable care organization (ACO) is a network of providers that agree to take on financial responsibility for the cost of care, the health outcomes and the consumer experience of care for a defined population. ACOs aim to transform the delivery system by moving away from fee-for-service payment arrangements toward value-based payments that reward effective and efficient care.

For many employers, growth in consumer-directed health plans (CDHP) has led them to turn to the supply-side of health care. With fewer plan design levers available in a CDHP environment, employers are looking at ACOs as an option to provide employees with higher-quality, lower-cost and more consumer-focused health care. However, employers are still uncertain if ACOs deliver better value than the current market.

This toolkit provides employers with a road map on implementing an ACO strategy from assessing market opportunity, understanding ACO readiness, considering plan design options, improving employee engagement and evaluating ACO performance. Members of the National Business Group on Health's Executive Committee on Value Purchasing supported the development of this work.

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