Exhibit 4. Organizational characteristics of ACOs that serve high proportions of minority patients compared to all other ACOs.

Organizational characteristics of ACOs that are high proportion minority patients (75^th percentile or above) compared to all other ACOs; data from the National Survey of ACOs, authors’ calculations

	High minority ACOs (N=45)	Other ACOs (N=169)	Significance
Composition
Hospital in ACO	0.43	0.51
Community health center in ACO	0.38	0.25
Nursing facility in ACO	0.26	0.20
Integrated delivery system	0.39	0.48
Services offered within the ACO
Routine specialty care	0.57	0.74	**
Highly specialized care	0.30	0.23
Emergency Care	0.49	0.57
Urgent care	0.64	0.66
Inpatient rehabilitation	0.31	0.43
Outpatient rehabilitation	0.29	0.50	**
Behavioral health	0.45	0.54
Skilled nursing	0.30	0.34
Pediatric health	0.40	0.59	**
Palliative or hospice care	0.30	0.53	***
Home health	0.48	0.51
Contracts
Medicaid ACO contract	0.15	0.17
Private payer ACO contract	0.26	0.51	***
Multipayer ACO	0.20	0.39	***
Capabilities
All clinicians on single EMR	0.11	0.23
ACO actively engaged in improving ambulatory care	0.45	0.53
ACO involved in reducing hospital admissions	0.44	0.37
Smooth transitions of care across settings	0.22	0.20
Chronic care management processes and programs in place	0.42	0.32

Source: Authors’ analysis of the National Survey of Accountable Care Organizations and Centers for Medicare and Medicaid Services Shared Savings Program (MSSP) ACO Public Use File (see Notes 24 and 25 in the text).

Notes: ACOs that serve high proportions of racial and ethnic minorities are in the 75^th percentile or above. ED is emergency department. EMR is electronic medical record.

^*p < 0.10

^**p < 0.05

^***p < 0.01

^****p < 0.001