Table 1.

Data and Measures of ACO Competencies Derived from AHA Annual Survey and HIMSS Analytics Data

ACO Competencies	Description	Source and Definition of ACO Measure
Linkages with physicians	Arrangements with primary care physicians and specialists through a variety of physician organization arrangements.	AHA Annual Survey: Number of physicians in physician-organization arrangements (POAs) per 1,000 inpatient days, measured separately for (1) tightly integrated POAs (integrated salary, equity, foundation models, management service organizations); and (2) loosely integrated POAs (group practices without walls, independent practice associations, open physicians-hospital organizations, closed physicians-hospital organizations).
Linkages with ambulatory facilities on a continuum of care	Linkages with services provided through hospital and outpatient providers to coordinate care across the continuum and facilitate comprehensive care across the population in a geographic area.	AHA Annual Survey: Count of five ambulatory care services offered by a hospital: (1) freestanding outpatient center, (2) hospital-based outpatient care center, (3) primary care department, (4) home care, and (5) urgent care.
HIT infrastructure	HIT capabilities that allow the practice of evidence-based medicine, patient engagement, care coordination, and reporting of quality and cost measures.	HIMSS Analytics: Count of five basic HIT applications for (1) pharmacy, (2) laboratory, (3) radiology information systems, (4) clinical data repository, and (5) clinical decision support. Count of two advanced HIT applications for (1) nursing documentation and (2) electronic medication administration.

Notes: AHA is American Hospital Association; HIMSS is the Health Information and Management System Society