--- title: "From small area variations to accountable care organizations: how heal | Sutter Health" description: "Health services research is characterized as policy-driven research. Research-driven policy, occures when studies alter perceived realtiy leading to new policy." url: "https://www.sutterhealth.org/research/publications/small-variations-to-accountable-care-organizations-1055312595" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. From small area variations to accountable care organizations: how heal # From small area variations to accountable care organizations: how health services research can inform policy Luft HS. _Annu Rev Public Health. 33:377-92. doi: 10.1146/annurev-publhealth-031811-124701. Epub 2012 Jan 3._ 2012-04-01 ## Abstract Much of health services research seeks to inform particular policy choices and is best characterized as policy -driven research . The reverse, research -driven policy , occurs when studies alter how people perceive reality, which eventually leads to new policy . An example of the latter is nearly four decades of work by John Wennberg and colleagues. Observing variations in practice across small geographic areas led to the notion that some care is preference sensitive, whereas other care is supply constrained. For the former, patient, rather than physician, preferences should be honored, after acquiring and effectively communicating the best available information on the benefits and risks of treatment options. Finding that areas with high use of services have no better quality or outcomes than do areas with lower use led to the notion of accountable care organizations (ACOs). Eventually, both patient engagement and ACOs were written into the Affordable Care Act of 2010. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/?term=From+small+area+variations+to+accountable+care+organization) ## Research topics - [Health Policy](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Policy%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Commentary: It's more than just the price.](https://www.sutterhealth.org/research/publications/commentary-its-more-than-just-the-price-1055312869) Health Serv Res. 2020 Aug;55(4):496-499. doi: 10.1111/1475-6773.13317. 2020 Aug 01 - Publication ### [Three political realities in expanding coverage for the working poor: one state's experience.](https://www.sutterhealth.org/research/publications/expand-coverage-wking-poor-one-state-1055312625) Kinney ED, Tai-Seale M, Greene JY, Murray R, Tierney W. Health Aff (Millwood). 18(4):188-92. 1999 Jul 01 - Publication ### [Assignment, attribution, and accountability: new responsibilities and relationships in accountable care organizations.](https://www.sutterhealth.org/research/publications/assignment-attribution-accountability-in-acas-1055312910) Luft HS. Virtual Mentor. 14(5):407-10. doi: 10.1001/virtualmentor.2012.14.5.pfor1-1205. 2012 May 01 - Publication ### [Capacity building for assessing new technologies: approaches to examining personalized medicine in practice.](https://www.sutterhealth.org/research/publications/capacity-building-for-assessing-new-technologies-1055312563) Van Bebber SL, Trosman JR, Liang SY, Wang G, Marshall DA, Knight S, Phillips KA. Per Med. 7(4):427-439 2010 Jul 01 - Publication ### [CMS changes in reimbursement for HAIs: setting a research agenda](https://www.sutterhealth.org/research/publications/cms-changes-in-reimbursement-for-hais-1055312566) Stone PW, Glied SA, McNair PD, Matthes N, Cohen B, Landers TF, Larson EL. Med Care. 48(5):433-9. doi: 10.1097/MLR.0b013e3181d5fb3f. 2010 May 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/small-variations-to-accountable-care-organizations-1055312595#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"From small area variations to accountable care organizations: how heal"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/small-variations-to-accountable-care-organizations-1055312595#medicalscholarlyarticle","name":"From small area variations to accountable care organizations: how health services research can inform policy","headline":"From small area variations to accountable care organizations: how heal","abstract":"Much of healthservicesresearch seeks to inform particular policy choices and is best characterized as policy-driven research. The reverse, research-driven policy, occurs when studies alter how people perceive reality, which eventually leads to new policy. An example of the latter is nearly four decades of work by John Wennberg and colleagues. Observing variations in practice across small geographic areas led to the notion that some care is preference sensitive, whereas other care is supply constrained. For the former, patient, rather than physician, preferences should be honored, after acquiring and effectively communicating the best available information on the benefits and risks of treatment options. Finding that areas with high use of services have no better quality or outcomes than do areas with lower use led to the notion of accountablecareorganizations (ACOs). Eventually, both patient engagement and ACOs were written into the Affordable Care Act of 2010.","description":"Health services research is characterized as policy-driven research. Research-driven policy, occures when studies alter perceived realtiy leading to new policy.","keywords":["Health Policy"],"datePublished":"2012-04-01","url":"https://www.sutterhealth.org/research/publications/small-variations-to-accountable-care-organizations-1055312595","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"DOI","value":"10.1146/annurev-publhealth-031811-124701"}],"sameAs":["https://doi.org/10.1146/annurev-publhealth-031811-124701"],"isPartOf":{"@type":"Periodical","name":"Annu Rev Public Health"},"author":[{"@type":"Person","name":"Luft HS"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Health Policy","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Policy%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/small-variations-to-accountable-care-organizations-1055312595","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/small-variations-to-accountable-care-organizations-1055312595#breadcrumblist"}}} ```