Coordination mechanisms in four accountable care organizations

Brian Hilligoss, Paula H. Song, Ann Scheck McAlearney

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


New organization theory posits that coordination mechanisms work by generating three integrating conditions: accountability (clarity about task responsibilities), predictability (clarity about which, when, and how tasks will be accomplished), and common understanding (shared perspectives about tasks). We apply this new theory to health care to improve understanding of how accountable care organizations (ACOs) are attempting to reduce the fragmentation that characterizes the US health care system. Drawing on four organizational case studies, we find that ACOs rely on a wide variety of coordination mechanisms that have been designed to leverage existing organizational capabilities, accommodate local contingencies. and, in some instances, interact strategically. We conclude that producing integrating conditions across the care continuum requires suites of interacting coordination mechanisms. Our findings provide a conceptual foundation for future research and improvements.

Original languageEnglish (US)
Pages (from-to)207-232
Number of pages26
JournalInternational Journal of Organization Theory and Behavior
Issue number2
StatePublished - Jun 1 2016

ASJC Scopus subject areas

  • Applied Psychology
  • Public Administration
  • Organizational Behavior and Human Resource Management


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