Article
Medicine, General & Internal
Helen Newton, Susan H. Busch, Mary Brunette, Donovan T. Maust, James O'Malley, Ellen R. Meara
Summary: Most ACOs do not fully implement all collaborative care components, with the majority using care managers and consulting mental health clinicians, but fewer utilizing patient registries. ACOs responsible for mental health care quality measures are more likely to implement collaborative care, indicating the potential impact of payment contracts on encouraging this cost-effective model.
Article
Radiology, Nuclear Medicine & Medical Imaging
Stefan Santavicca, Richard Duszak, Gregory N. Nicola, Lauren Parks Golding, Andrew B. Rosenkrantz, Christian Wernz, Danny R. Hughes
Summary: Between 2013 and 2018, the participation of radiologists in MSSP ACOs increased significantly, with larger ACOs having higher percentages of radiologist participation. ACOs with radiologists had more diverse physician specialties and a higher rate of specialist representation compared to ACOs without radiologists. Demographics of beneficiaries were similar regardless of radiologist participation in ACOs.
JOURNAL OF THE AMERICAN COLLEGE OF RADIOLOGY
(2021)
Article
Public, Environmental & Occupational Health
N. Baker, P. M. Singer
Summary: This study examines the regulatory landscape of accountable care organizations (ACOs) in the United States and its impact on organizational participation. The study analyzes existing and prior regulations governing ACOs and investigates the changes in ACO participation over time.
Review
Health Care Sciences & Services
Cristian Lieneck, Eric Weaver, Thomas Maryon
Summary: Ambulatory healthcare providers participating in Accountable Care Organizations (ACOs) incur costs beyond typical practice operations related to value-based care initiatives. COVID-19 pandemic prompted CMS to issue waivers for ACO reporting requirements, allowing researchers to study variables influencing costs for ambulatory care organizations participating in ACOs. Findings identified variables like enhanced patient care management, health information technology improvements, and organizational ownership/reimbursement models reducing costs for ambulatory care organizations.
Article
Public, Environmental & Occupational Health
Svetlana Beilfuss, Sebastian Linde, Brandon Norton
Summary: This study examines the impact of Medicare ACO programs on physician antibiotic prescribing. It finds that ACO affiliation is associated with a significant decrease in antibiotic prescriptions, with an average reduction of about 20.4 prescriptions per year. The study also shows that the treatment effects vary across different specialties.
SOCIAL SCIENCE & MEDICINE
(2022)
Article
Orthopedics
Joshua M. Liao, Eric Z. Shan, Yueming Zhao, Yash Shah, Deborah S. Cousins, Amol S. Navathe
Summary: This study examines the overlap between Medicare's Comprehensive Care for Joint Replacement (CJR) model and accountable care organizations (ACOs), identifying differences in patient and hospital characteristics. Patients in the overlap group were less likely to be older, of black race, and of low socioeconomic status compared to CJR-only patients, while high overlap hospitals were more likely to be nonprofit institutions.
JOURNAL OF ARTHROPLASTY
(2021)
Article
Health Care Sciences & Services
Molly Frean, Christian Covington, Maike Tietschert, Hassina Bahadurzada, Jodi So, Sara J. Singer
Summary: Despite features that theoretically promote integrated care, such as ACOs and MA, this study found that patient-perceived integrated care is largely similar across different types of coverage in the Medicare system.
Article
Geriatrics & Gerontology
Joan M. Teno, Laura M. Keohane, Susan L. Mitchell, David J. Meyers, Jennifer N. Bunker, Emmanuelle Belanger, Pedro L. Gozalo, Amal N. Trivedi
Summary: The study compared end-of-life care for dementia patients in different healthcare plans, finding that patients in Medicare Advantage (MA) experienced less costly and burdensome care compared to those in traditional Medicare (TM) and ACOs.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2021)
Article
Health Care Sciences & Services
Jennifer Perloff, Sam Sobul
Summary: This study assesses the ability of accountable care organizations (ACOs) to use electronic health record (EHR) data and finds that the usage of multiple EHR systems among ACOs may cause delays when reporting quality measures through EHRs.
AMERICAN JOURNAL OF MANAGED CARE
(2022)
Article
Surgery
Victor H. Lopez, Kristina Vatcheva, Monica M. Betancourt-Garcia, Angel Dono, Ricardo D. Martinez, Robert Armour Forse
Summary: This study found that the implementation of accountable care organizations resulted in increased disease severity, more emergency admissions, higher utilization of computed tomography scans for diagnosis, prolonged length of stay, and increased costs for patients with acute cholecystitis.
Article
Medicine, General & Internal
Meng-Yun Lin, Amresh D. Hanchate, Austin B. Frakt, James F. Burgess, Kathleen Carey
Summary: Physician-hospital integration in accountable care organizations (ACOs) has raised concerns about the impact on prices and spending. This study examined differences in patient population, organizational characteristics, and healthcare spending among 16 commercial ACOs in Massachusetts based on levels of integration. High-integrated and medium-integrated ACOs were more likely to be integrated delivery systems with a larger number of providers. Higher-integrated ACOs had higher healthcare spending, driven by outpatient facility services, even after adjusting for organizational characteristics and patient mix.
Article
Health Care Sciences & Services
A. Gaffney, S. Woolhandler, D. U. Himmelstein
Summary: Over the past century, the tax-financed share of health care spending in the US has increased from 9% in 1923 to 69% in 2020, with a large part of it being used to subsidize private health insurance. The ownership of for-profit health care facilities has also grown, along with a rising number of physicians who are now employees. This trend of publicly financed yet investor-owned health care in the US has led to rising medical costs and worsening population health, calling for a reevaluation of the country's health care financing and ownership.
Article
Health Care Sciences & Services
Kenton J. Johnston, Travis Loux, Karen E. Joynt E. Maddox
Summary: This study compares ACO enrollment and care patterns for patients with and without dementia, and finds that patients with dementia are less likely to enroll and retain in ACOs compared to those without dementia. However, ACO-enrolled dementia patients have a more favorable health risk profile. In terms of care patterns, ACO enrollment is associated with higher wellness visit rates and more fragmented primary care.
Article
Oncology
Parsa Erfani, Jessica Phelan, E. John Orav, Jose F. Figueroa, Ashish K. Jha, Miranda B. Lam
Summary: This study found that accountable care organizations (ACOs) did not significantly impact cancer spending for patients in the first 4 years after implementation, compared to non-ACOs. The lack of difference in spending between ACO and non-ACO practices prompts a reevaluation of the current efficacy of ACOs in reducing spending for cancer care.
Article
Medicine, General & Internal
Rushina Cholera, David M. Anderson, Richard Chung, Jessica Genova, Peter Shrader, William K. Bleser, Robert S. Saunders, Charlene A. Wong
Summary: Despite the momentum for pediatric value-based payment models, there is limited knowledge on tailoring design elements to meet the unique needs and utilization patterns of children and young adults. This study aimed to simulate attribution to a hypothetical pediatric accountable care organization (ACO) and provide insights into baseline characteristics, expenditures, and utilization patterns over the subsequent year.