The 1990s. Hip-hop and grunge arrived on the national scene. Mariah Carey was artist of the decade. The Berlin Wall fell. The Internet was commercialized. And, health care provider organization strategies to form risk-bearing organizations (PHOs, MSOs, IDNs, etc.) flopped. The failures of these organizations are the reason for skepticism about the likely success of accountable care organizations (ACOs) – and skepticism about moving to value-based purchasing for provider organizations.

Opinions on ACOs vary. For every Ezekiel J. Emanuel predicting the primacy of ACOs over traditional insurance organizations (see The End of Health Insurance Companies), there is a . . .

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