Elliott Fisher, MD, Geisel School of Medicine Professor, came to Dartmouth from Harvard in 1986 for the chance to work with health cost variations pioneer Jack Wennberg, MD. Wennberg published the first article in Science in 1973 that showed 10-fold differences in the rate of surgery across Vermont, and two-fold differences in rates of spending for surgery across Vermont. Wennberg's and Fisher's work has led to the creation of the Accountable Care Organization (ACO) model, which compels physicians and health care organizations to transparently report on the outcomes and quality of their care to gauge how well they're performing. The end goal is moving from a fragmented system focused on volume and fee-for-service care to a system that rewards physicians and hospitals for improving care outcomes within an organized system.
10% of all Americans are now receiving care within an organization that has an ACO contract.