April 2018. Peris D, News M, Nallaiah K.

There is increasing interest around the globe in accountable care organisations (ACOs) as models of health system reform that have the potential to improve health outcomes and patient experience, while containing or reducing costs of care. This review describes the purpose and features of 146 ACO models from nine countries and examines the evidence of their effectiveness in achieving this triple aim. The authors conclude that the evidence base is immature, with evaluations of these models early in their evolution and dominated by low-quality studies. Ten models were selected for a more detailed analysis of barriers and enablers to their implementation and this analysis highlights several implementation factors that may help to drive success, many of which align with existing initiatives in the NSW Health system.