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Willingness to Participate in Accountable Care Organizations: Health Care Managers’ Perspective

Wan, Thomas T.H. PhD, MHS; Demachkie Masri, Maysoun DSc, MPH; Ortiz, Judith PhD, MBA; Lin, Blossom Y. J. PhD

doi: 10.1097/01.HCM.0000440625.92879.e8

This study examines how health care managers responded to the accountable care organization (ACO). The effect of perceived benefits and barriers of the commitment to develop a strategic plan for ACOs and willingness to participate in ACOs is analyzed, using organizational social capital, health information technology uses, health systems integration and size of the health networks, geographic factors, and knowledge about ACOs as predictors. Propensity score matching and analysis are used to adjust the state and regional variations. When the number of perceived benefits is greater than the number of perceived barriers, health care managers are more likely to reveal a stronger commitment to develop a strategic plan for ACO adoption. Health care managers who perceived their organizations as lacking leadership support or commitment, financial incentives, and legal and regulatory support to ACO adoption were less willing to participate in ACOs in the future. Future research should gather more diverse views from a larger sample size of health professionals regarding ACO participation. The perspective of health care managers should be seriously considered in the adoption of an innovative health care delivery system. The transparency on policy formulation should consider multiple views of health care managers.

Author Affiliations: College of Health and Public Affairs (Dr Wan), Department of Health Management and Informatics (Dr Masri), and Rural Health Research Group (Dr Ortiz), College of Health and Public Affairs, University of Central Florida, Orlando, Florida; and Department of Health Care Administration and Policy, China Medical University, Taichung, Taiwan (Dr Lin).

This research, in part, is supported by a federal grant U24MD006954 from the National Institute on Minority Health and Health Disparities, National Institutes of Health.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

The authors report no conflicts of interest.

Correspondence: Thomas T. H. Wan, PhD, MHS, PO Box 163280, Orlando, FL 32816-3680 (

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins