Accountable care organizations, the patient-centered medical home, and health care reform: what does it all mean?

Medical care in the United States is plagued by extremely high costs, poor quality, and fragmented delivery. In response, new concepts of integrated health care delivery have developed, including patient-centered medical homes and accountable care organizations (ACOs). This article reviews these concepts and includes a detailed discussion of the Centers for Medicare and Medicaid Services' ACO and Shared Savings Proposed Rule.