Accountable care organizations (ACOs) have shown promise in improving care for individuals with chronic conditions who also have coexisting mental health conditions, in part by incentivizing hospitals to integrated care coordination strategies. This study examined whether hospital affiliation with an ACO led to reduced preventable hospitalizations for patients with comorbid physical and mental conditions, and how ACO care coordination strategies affected racial and ethnic health disparities.

Hospitals with an ACO affiliation had lower preventable hospitalizations for heart disease, asthma, diabetes, and hypertension among patients with coexisting depression, across all racial and ethnic groups. ACO-affiliated hospitals adopted varied care coordination strategies, such as hospitalists for medical/surgical inpatients and medication reconciliation, and the effectiveness of the strategies varied by patients’ race.

These results emphasize that ACO affiliation, as well as tailored care coordination strategies among ACO hospitals, may lead to lower preventable hospitalization rates and reduced racial disparities among patients with comorbid physical and mental health conditions. Care coordination strategies in ACOs must be tailored to meet the needs of specific patient populations, and can be designed to target both: (1) integration of physical and mental health; and (2) reductions in health disparities.