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Analysis of 2016 Connecticut ACO Medicare Shared Savings Program Data to Identify Opportunities for Population Health Pharmacist Services

Kathryn Steckowych, PharmD; Marie Smith, PharmD; and Yan Zhuang, PhD
Publicly reported Medicare Shared Savings Program accountable care organization (ACO) data can be analyzed to identify cost and medication-related quality performance improvement opportunities to support pharmacist integration into ACO population health services.
ABSTRACT

Objectives: To discuss the use of publicly reported Medicare Shared Savings Program (MSSP) accountable care organization (ACO) data to determine cost and medication-related quality performance improvement opportunities, analyze Connecticut MSSP ACO cost and quality performance data to identify significant findings and directional trends, and demonstrate how clinical pharmacy leaders can use this analytical approach to facilitate conversations with ACO executive leaders for pharmacist service integration. 

Methods: The 2016 MSSP ACO data set was used to analyze cost and medication-related quality performance metrics for 13 Connecticut ACOs. Research questions were formulated to identify significant (1) correlations between 30-day all-cause hospital readmission (HR) or emergency department (ED) utilization rates and ACO cost or medication-related quality metric performance and (2) associations between ACO governance and ACO cost or medication-related quality metric performance. Descriptive trends analyses were performed to explain differences in cost and medication-related quality performance according to ACO governance.

Results: Statistically significant correlations were identified between (1) HR and/or ED utilization rates and several per capita expenditures or medication-related quality performance metrics and (2) ACO governance and per capita total expenditures or per capita skilled nursing facility expenditures. Looking at directional trends, health system–governed ACOs had greater total and per capita expenditures for all cost performance metrics, except per capita physician/supplier expenditures. Physician-governed ACOs performed better on all medication-related quality metrics.

Conclusions: Analysis of publicly reported MSSP ACO data can identify cost and medication-related quality performance improvement opportunities. Pharmacists can use such data for conversations with C-suite executive leaders about integrating population health pharmacist services in ACOs.

The American Journal of Accountable Care. 2018;6(4):e1-e10

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