Pilot ACOs Miss Opportunities to Curb Cardiovascular Spending

In a study of 10 large health systems, Dartmouth investigators found that implementation of pilot accountable care organizations did not limit spending on discretionary or non-discretionary cardiovascular treatment for patients.

In a study of 10 large health systems, Dartmouth investigators Carrie H. Colla, PhD, Philip P. Goodney, MD, MS, and Ellen R. Meara, PhD, and others from Dartmouth and the University of Michigan found that implementation of pilot accountable care organizations (ACOs) did not limit spending on discretionary or non-discretionary cardiovascular treatment for patients.

Published in Circulation, their paper demonstrates that health systems need to directly consider specialty care in order to achieve meaningful savings. The paper is titled, "Implementation of a Pilot Accountable Care Organization Payment Model and the Use of Discretionary and Nondiscretionary Cardiovascular Care."

"We found that, when an ACO payment model was implemented, evidence-based treatments for patients with cardiovascular disease, such as heart attack or stroke, were provided consistently," said Colla. "That's a good thing. However, we also found that discretionary tests and procedures, such as stress tests for people without symptoms, were still being commonly ordered. We hypothesized that pilot ACOs would target these discretionary treatments to help lower spending, but that didn't happen. For ACOs, which need to focus on limiting spending on discretionary treatments, this is a missed opportunity."

Read the press release from Dartmouth: http://bit.ly/1CC9c2S