The number of accountable care organizations (ACOs) has grown rapidly over the last 4 years, with more than 800 ACOs now covering an estimated 28 million Americans. A study found that commercial ACOs were significantly larger and more integrated with hospitals and had lower benchmark expenditures and high quality scores compared with noncommercial ACOs.
The number of accountable care organizations (ACOs) has grown rapidly over the last 4 years, with more than 800 ACOs now covering an estimated 28 million Americans, and it is expected that the number of ACOs will quadruple over the next 5 years.
Using data from national surveys of 399 ACOs from 2012 to 2015, a group of researchers led by David Peiris, MBBS, PhD, MIPH, of the Harvard T.H. Chan School of Public Health examined differences between the 228 commercial ACOs (those with commercial payer contracts) and 171 noncommercial ACOs (those with only public payer contracts such as Medicare or Medicaid) and found that ACOs with commercial contracts outperform ACOs with public-payer contracts on selected measures of quality and process efficiency. The differences in performance are linked to variation in organizational structure, provider compensation, quality improvement activities, and management systems, and the study concludes that the public sector should play a lead role in supporting and guiding the future growth of ACOs if they are to achieve desired quality and efficiency gains. The study was published in Health Affairs.
Commercial ACOs were significantly larger and more integrated with hospitals, and had lower benchmark expenditures and higher quality scores, compared with noncommercial ACOs. Among all of the ACOs, there was low uptake of quality and efficiency activities. But the study found that commercial ACOs reported more use of disease-monitoring tools, patient satisfaction data, and quality improvement methods than noncommercial ACOs did. Furthermore, the study found that few ACOs reported having vigorous quality-monitoring capabilities or having financial incentives tied to quality.
Other findings included the following:
ACO leaders and policy makers must focus on organizational structure, health information technology, physician engagement and incentives, and quality improvement if desired improvements in quality and efficiency in ACOs are to occur. Currently, ACOs are early in their evolution and many currently lack essential building blocks to bring about needed improvements in quality and efficiency, the authors believe.
Both commercial and noncommercial ACOs need to make large investments in critical infrastructure in order to support delivery system reform, the investigators wrote, particularly coordination of quality-improvement activities and related financial incentives for physicians and improved information technology platforms.
Study Highlights Significant Increases in Utilization, Spending on DMD Drugs in Medicaid
May 17th 2024The findings add to recent research on the growing utilization, expenditure, and prices of Duchenne muscular dystrophy (DMD) therapies in the current landscape, an area health care policy could potentially address.
Read More
Frameworks for Advancing Health Equity: Urban Health Outreach
May 9th 2024In the series debut episode of "Frameworks for Advancing Health Equity," Mary Sligh, CRNP, and Chelsea Chappars, of Allegheny Health Network, explain how the Urban Health Outreach program aims to improve health equity for individuals experiencing homelessness.
Listen
Panel Addresses Minority Physician Shortage, Maternal Health at Senate Committee Hearing
May 15th 2024The senate hearing held by the US Senate Committee on Health, Education, Labor, and Pensions, led by Sen. Bernie Sanders (I, Vermont), chairman of the committee, and ranking member Sen. Bill Cassidy, MD, (R, Louisiana), addressed the critical issue of physician and health care worker shortages, as well as the maternal health crisis, in the US.
Read More
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
Listen
A new study highlights significant disparity in reimbursement rates across states between hospitals and Medicare; the first patient to receive a genetically modified pig kidney has died; research examines outcomes of over 500 patients receiving medication abortion pills by mail.
Read More