Medicare ACOs Achieve Savings When Treating Patients With Comorbidities

A new analysis by the Dartmouth Institute has found that Medicare accountable care organizations (ACOs) are making modest yet increasing gains when treating patients with comorbidities. These patients are usually responsible for the highest spending.

Published in JAMA Internal Medicine, the study analyzed the impact of 252 Medicare ACOs from 2012 through 2013. The outcomes measured included total spending per beneficiary-quarter, spending categories, use of hospitals and emergency departments, ambulatory care sensitive admissions, and 30-day readmissions. The authors found that Medicare ACOs saved about $136 per patient annually due to a reduction in hospital care and skilled nursing facility care. Quite significantly patients who were treated for more than 3 conditions saw an annual saving of $456 per patient.

Overall, hospitalizations and emergency department visits decreased by 1.3 and 3.0 events per 1000 beneficiaries every quarter among the Medicare patients. Amongst those who were clinically more vulnerable, they reduced by 2.9 and 4.1 events per 1000 beneficiaries, per quarter, respectively.

Based on their findings, the authors conclude that savings were realized through reductions in use of institutional settings in clinically vulnerable patients.

According to lead author Carrie Colla, PhD, “With Medicare ACOs, the majority of the savings is concentrated on patients with complex medical needs, indicating that coordinated care is likely a factor in being able to more efficiently treat chronic illness.”