Date of Award

Spring 4-16-2016

Document Type


Degree Name

Doctor of Education (EdD)


Organizational Leadership

First Advisor

Dr. Walter Buster, Chair

Second Advisor

Dr. Daniel Custor

Third Advisor

Dr. Michelle Neal


In 2010, President Obama enacted comprehensive healthcare reform in the United States, the Patient Protection and Affordable Care Act (ACA), which was designed to provide medical benefits to 4.3 million uninsured Americans and reduce healthcare expenditures while improving quality of care and patient outcomes. The law included the creation of the accountable care organization (ACO), a healthcare delivery and financial model with physicians at the center of the ACO who play a significant role in the success or failure of the model. The current study explored the physician’s level of knowledge about the ACO model’s Triple Aim goals and performance measures, as well, how the ACO requirements affected their ability to meet patient needs. The study employed a quantitative research design using original data collected through electronic survey from a sample of physicians in southern California ACOs. Analyses of the data showed a gap of knowledge of the Triple Aim goals, quality performance domains, and aspects of performance indicators of the current ACO model. Findings showed most aspects of the ACO requirements had a slightly positive impact on the physicians’ ability to meet patient needs inside southern California-based ACOs. The physician perspective also illuminated competing goals for delivering care while reducing costs under the model’s current design. Concluded by this study, improvements are needed in education and professional training to (1) close the knowledge gap among physicians, (2) implement the tenets of systems thinking, (3) outsource technology, (4) let physicians clinical experts, and (5) shift the ACO culture to a learning organization.