One ACO, many systems

Stand-alone accountable care organizations (ACOs) are asked to do something structurally and operationally difficult: They accept accountability for the total cost and quality of a defined population that receives care across organizations the ACO does not own, documented in electronic health records the ACO does not control, in settings the ACO often cannot see into. Substantial investment has gone into closing that gap through analytics and platform strategy. The constraint that remains sits one layer below both of these solutions. That constraint is identity.