Total paper length : 6 pages-page 1 is the title page ; 2-5 is the content typed & double-spaced & page 6 is the bibliography. Please download the sample paper format for additional instructions and paper presentation format.. 1. As managed care has evolved, new delivery systems have been established. One such deliverysystem is the Accountable Care Organization (ACO) . Describe the ACO its beginnings, overallobjectives, its structure and key features. Managed care companies are partnering with providersto establish ACO’s. Discuss the positive or negative impact the ACO will have on reducinghealth care costs while producing quality outcomes.