accountable Care Organizations (ACOs) are recognized as innovative solutions for cost management and quality improvement in healthcare systems. These organizations bear financial and clinical responsibility for providing care to a defined population of patients. The present study aimed to examine the outcomes of ACOs in healthcare systems.

The present systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The searches were performed using keywords, such as "Accountable Care Organizations" and "Integrated Care," in databases, including PubMed, Scopus, Web of Science (WOS), Scientific Information Database (SID), Magiran, IranMedex, and Google Scholar. Searches were conducted individually and in combination, covering the period from January 1, 2000, to May 13, 2024. The quality of articles was assessed using the Critical Appraisal Skills Programme (CASP) and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklists. Eligible studies were selected, and their findings were analyzed.

Among 8720 articles identified using the keywords, 21 studies with relevant titles, abstracts, and full texts were reviewed. The most significant outcome of ACOs across studies was healthcare cost reduction (48%), followed by improved quality of care services (32%) and enhanced public health (23%). Additional outcomes (29%) included ensuring successful provider experiences, reducing low-value services, patient-centered care, standardizing clinical processes, and managing high-risk patients.

An ACO acts as a driving force in the healthcare system, simultaneously minimizing treatment costs and optimizing resource management. On one hand, it revolutionizes the patient experience and elevates the quality of care to unprecedented levels. On the other hand, it fosters a healthier society where prevention takes precedence over treatment, and health is regarded as a collective asset. Therefore, it is recommended that healthcare systems, including those located in Iran, leverage the principles of accountable care to enhance service quality while reducing costs.