Dr Mariétou Ouayogodé on Predictors of ACO Performance on Preventive Care

An analysis of Medicare accountable care organizations (ACOs) revealed that those with more primary care physicians performed better on preventive care quality measures and infrastructure and financing were also predictive of better performance, explained Mariétou Ouayogodé, PhD, post-doctoral fellow at The Dartmouth Institute for Health Policy and Clinical Practice at the Geisel School of Medicine at Dartmouth.

Transcript

What have you learned about the quality of care in Medicare accountable care organizations?

What we've learned from our analysis was mainly that preventive care quality measures are very much correlated and so when we used our data reduction tool, which was the exploratory factor analysis, we could segment them into 2 main subgroups. So we had some measures describing disease prevention and then on the other side we had wellness screening measures.

When we took it to more analysis to examine associations with ACO characteristics we came to that analysis with expectations that probably the size of an ACO as measured with beneficarcy composition or even physician composition could be predictive of performance on preventive care quality.

But when we looked at size as measured with the number of attributed beneficiaries, we don't see that significant prediction being there. But when we control for that we found that ACOs performed significantly worse when they had fewer primary care providers and too many specialists. So that's what we've learned, and we've also learned that some characteristics with ACOs related to infrastructure and financing were actually predictive of better performance on disease prevention—so preventive care quality, in general.