What Can Canada Learn From Accountable Care Organizations: A Comparative Policy Analysis

Allie Peckham, David Rudoler, Dominika Bhatia, Sara Allin, Reham Abdelhalim, Gregory P. Marchildon

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Introduction: Accountable Care Organizations (ACOs), implemented in the United States (US), aim to reduce costs and integrate care by aligning incentives among providers and payers. Canadian governments are interested adopting such models to integrate care, though comparative studies assessing the applicability and transferability of ACOs in Canada are lacking. In this comparative study, we performed a narrative literature review to examine how Canadian health systems could support ACO models. Methods: We reviewed empirical studies (published 2011–2020) that evaluated ACO impacts in the US. Thematic analysis and critical appraisal were performed to identify factors associated with positive ACO impacts. These factors were compared with the Canadian context to assess the applicability and transferability of ACO models within Canada. Findings: Physician-led models, global budgets and financial incentives, and focus on collaborative care may optimize ACO impacts. While reforms towards alternative payments and team-based care are not unprecedented in Canada, significant further reforms to physician remuneration, intersectoral collaboration, and accountability for performance are required to support ACO-like models. Conclusion: This comparative study uncovered several insights on the applicability and transferability of ACOs to the Canadian context. Further comparative research outside the US is needed to infer the essential components of successful ACO models.

Original languageEnglish (US)
Article number1
JournalInternational Journal of Integrated Care
Issue number1
StatePublished - 2022
Externally publishedYes


  • Accountable care organizations
  • Canada
  • United States
  • comparative policy analysis
  • integrated care models
  • narrative review

ASJC Scopus subject areas

  • Health(social science)
  • Sociology and Political Science
  • Health Policy


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