The study by Erfani et al. confirms that ACOs did not achieve the promise of cancer care cost reduction, but leaves open important questions about the impacts of accountable care on the quality, coordination, and equity of cancer care delivery. While the inability of ACOs to deliver cost reductions for patients with cancer may feel like a step backwards for accountable care in oncology, the work of Erfani et al. actually represents an important step forward in the field, settling the important cost question in order to open a broader conversation on the goals of ACOs and value-based care delivery models in oncology, the means to evaluate them in a comprehensive, patient-centered manner, and the urgency of incorporating the needs and voices of diverse populations in the important work of cancer care delivery reform.
Keywords: accountable care organization; cancer care delivery; equity; quality of care; value-based care.