责任制保健组织(ACO)是奥巴马政府医疗改革大力推崇的一种新型医疗服务组织体系,以期在控制医疗费用的同时改善医疗服务质量与健康状况。这篇文章重点分析了ACO的付费机制、费用控制措施和质量衡量指标。同时描述ACO实施的基本步骤,包括分配会员和制定费用目标的方法。并进一步探讨了ACO如何能促进初级保健、健康教育和疾病管理等薄弱环节,如何能促进医疗服务模式从被动等待向主动服务转变。 The Responsible Care Organization (ACO) is a new medical service organization strongly advocated by the Obama administration for medical reform, with a view to improving the quality of medical services and health while controlling medical costs. This article focuses on the ACO’s payment mechanism, cost control measures, and quality metrics. It also describes the basic steps for ACO implementation, including ways to allocate members and set cost targets. And further explored how ACO can promote weak links such as primary health care, health education and disease management and how to promote the transformation of the medical service model from passive waiting to active service.