Module 2
Governance and Structure
The legal entity and governing body, aligning physician and hospital participants, and whether to build, buy, or join.
By the end of this module, you will be able to:
- Explain what an ACO governing body must include and what it decides
- Identify the incentive conflict a hospital-led ACO has to manage deliberately
- Choose between building, buying, and joining based on scale and capital
- Legal and Governance Structure An ACO is a governed entity, not a loose alliance. This lesson covers the legal form and the governing body that holds it together. About 4 min
- Aligning the Participants An ACO only works if its providers pull in the same direction. This lesson covers physician versus hospital leadership and how savings get distributed. About 5 min
- Build, Buy, or Join You do not have to build every ACO capability yourself. This lesson covers the make-versus-buy decision and the enablement partners that fill the gap. About 4 min
Module quiz
Answer all questions to see your score.
1. A Medicare ACO's governing body must include:
ACO governance is built around provider control and beneficiary representation, so those accountable for care shape how it runs.
2. Why have physician-led ACOs generally outperformed hospital-led ones?
Reducing admissions saves money but cuts hospital revenue; physician-led ACOs lack that internal conflict.
3. Why do small independent practices often join an ACO or partner with an enabler rather than build their own?
Bearing risk and running the infrastructure efficiently take scale and capital small practices usually lack, which is why enablers exist.