ObamaCare has a lot of incentives that are supposed to improve health care delivery. Plus, it has a lot of punishments that it imposes on those who deliver health care the old-fashioned way. The incentives are failing. However, the punishments might be leading to unintended outcomes that improve medical care.One example of a failing incentive is the Accountable Care Organization ACO. The term, ACO, is now used somewhat generically for any arrangement that shifts financial risk from a third-party payer to a provider. After all, who would endorse an Unaccountable Care Organization? However, in the strict legal sense, an ACO is an arrangement between the federal government and a provider, whereby the provider assumes some of the financial risk of delivering high-quality care to Medicare beneficiaries.This is supposed to result in savings for taxpayers. The results are poor: In the first year, less than one third of physician-led ACOs saved money, and only one fifth of hospital-led ACOs did. And the first year is the year in which the low-hanging fruit should have been easy to pick: The law of mean-reversion suggests that it will become increasingly difficult to find savings in future years.Why are the results so bad?