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ACO Accountable care organizations

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https://www.readbyqxmd.com/read/28075693/making-the-paradigm-shift-from-siloed-population-health-management-to-an-enterprise-wide-approach
#1
Marc R Matthews, Claudia Miller, Robert J Stroebel, Kari S Bunkers
Health systems across the United States have started their journeys toward population health management and the future of accountable care. Models of population health management include patient-centered medical homes and private sector accountable care organizations (ACOs). Other models include public sector efforts, such as Physician Group Practice Transition Demonstrations, Medicare Health Care Quality Demonstration Programs, Beacon Communities, Medicare Shared Savings Program, and Pioneer ACOs. As a result, health care organizations often have pockets of population health initiatives that lack an enterprise-wide strategy...
January 11, 2017: Population Health Management
https://www.readbyqxmd.com/read/28069848/aco-affiliated-hospitals-reduced-rehospitalizations-from-skilled-nursing-facilities-faster-than-other-hospitals
#2
Ulrika Winblad, Vincent Mor, John P McHugh, Momotazur Rahman
Medicare's more than 420 accountable care organizations (ACOs) provide care for a considerable percentage of the elderly in the United States. One goal of ACOs is to improve care coordination and thereby decrease rates of rehospitalization. We examined whether ACO-affiliated hospitals were more effective than other hospitals in reducing rehospitalizations from skilled nursing facilities. We found a general reduction in rehospitalizations from 2007 to 2013, which suggests that all hospitals made efforts to reduce rehospitalizations...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069847/acos-serving-high-proportions-of-racial-and-ethnic-minorities-lag-in-quality-performance
#3
Valerie A Lewis, Taressa Fraze, Elliott S Fisher, Stephen M Shortell, Carrie H Colla
Accountable care organizations (ACOs) are intended, in part, to improve health care quality. However, little is known about how ACOs may affect disparities or how providers serving disadvantaged patients perform under Medicare ACO contracts. We analyzed racial and ethnic disparities in health care outcomes among ACOs to investigate the association between the share of an ACO's patients who are members of racial or ethnic minority groups and the ACO's performance on quality measures. Using data from Medicare and a national survey of ACOs, we found that having a higher proportion of minority patients was associated with worse scores on twenty-five of thirty-three Medicare quality performance measures, two disease composite measures, and an overall quality composite measure...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28060052/evaluating-the-effects-of-pioneer-accountable-care-organizations-on-medicare-part-d-drug-spending-and-utilization
#4
Yuting Zhang, Kadin J Caines, Christopher A Powers
BACKGROUND: The improvement of medication use is a critical mechanism that accountable care organization (ACO) could use to save overall costs. Currently pharmaceutical spending is not part of the calculation for ACO-shared savings and risks. Thus, ACO providers may have strong incentives to prescribe more medications hoping to avoid expensive downstream medical costs. METHODS: We designed a quasinatural experiment study to evaluate the effects of Pioneer ACOs on Medicare Part D spending and utilization...
January 3, 2017: Medical Care
https://www.readbyqxmd.com/read/28045353/trends-in-the-inclusion-of-mental-health-providers-in-medicare-shared-savings-program-acos
#5
Julia Driessen, Yuting Zhang
OBJECTIVE: The study evaluated the presence of mental health providers in the Medicare Shared Savings Program (MSSP) accountable care organizations. METHODS: On the basis of data for all 105,155 providers participating in the 220 MSSPs in 2012 and 2013, MSSPs were classified by whether they included psychiatrists, psychologists, or clinical social workers. Descriptive statistics were calculated, including the number and type of mental health providers. RESULTS: The inclusion of mental health providers varied substantially over time and across MSSPs...
January 3, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28024312/factors-that-distinguish-high-performing-accountable-care-organizations-in-the-medicare-shared-savings-program
#6
Thomas D'Aunno, Lauren Broffman, Michael Sparer, Sumit R Kumar
OBJECTIVE: To identify factors that promote the effective performance of accountable care organizations (ACOs) in the Medicare Shared Savings Program. DATA SOURCES/STUDY SETTING: Data come from a convenience sample of 16 Medicare Shared Savings ACOs that were organized around large physician groups. We use claims data from the Center for Medicaid and Medicare Services and data from 60 interviews at three high-performing and three low-performing ACOs. STUDY DESIGN: Explanatory sequential design, using qualitative data to account for patterns observed in quantitative assessment of ACO performance...
December 26, 2016: Health Services Research
https://www.readbyqxmd.com/read/28017810/access-to-quaternary-care-surgery-implications-for-accountable-care-organizations
#7
J Hunter Mehaffey, Robert B Hawkins, Matthew G Mullen, Max O Meneveau, Bruce Schirmer, Irving L Kron, R Scott Jones, Peter T Hallowell
BACKGROUND: Accountable Care Organizations (ACO) attempt to provide the most efficient and effective care to patients within a region. We hypothesize that patients who undergo surgery closer to home have improved survival due to proximity of preoperative and post-discharge care. STUDY DESIGN: All (17,582) institutional American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) patients with a documented zip code and predicted risk who underwent surgery at our institution (2005-2014) were evaluated...
December 22, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27991749/medicare-accountable-care-organizations-quality-performance-by-geographic-categories
#8
Xi Zhu, Keith Mueller, Thomas Vaughn, Fred Ullrich, Clinton MacKinney
Purpose. This policy brief continues the work of the RUPRI Center analyzing the performance of Medicare Accountable Care Organizations (ACOs) serving rural areas. In this brief, we examine the differences in performance on four domains of quality measures and the overall quality score among Medicare Shared Savings ACOs with different levels of rural presence. Key Findings. (1) ACOs located in rural counties performed better than those in urban counties on Care Coordination/Patient Safety, Preventive Health, and At-Risk Population domain scores and the overall quality score in 2014...
2016: Rural Policy Brief
https://www.readbyqxmd.com/read/27991748/spread-of-accountable-care-organizations-in-rural-america
#9
Keith Mueller, Fred Ullrich
Purpose. The RUPRI Center for Rural Health Policy Analysis continues to monitor the spread of Medicare accountable care organizations (ACOs) into rural U.S. counties to determine whether this model appeals to rural providers and health systems. The RUPRI Center’s periodic reports reveal trends in rural ACO activity; this brief follows one released in July 2013, with data through December 2015. Key Findings. The following findings are based on activity through 2015: (1) Medicare ACOs operate in 41.8 percent of all nonmetropolitan counties...
2016: Rural Policy Brief
https://www.readbyqxmd.com/read/27982667/accountable-care-organization-hospitals-differ-in-health-it-capabilities
#10
Daniel M Walker, Arthur M Mora, Ann Scheck McAlearney
OBJECTIVES: The aim of this study was to evaluate health information technology (IT) adoption in hospitals participating in accountable care organizations (ACOs) and compare this adoption to non-ACO hospitals. STUDY DESIGN: A cross-sectional sample of US nonfederal, acute care hospitals with data from 3 matched sources: the 2013 American Hospital Association (AHA) Annual Survey, the 2013 AHA Survey of Care Systems and Payments (CSP), and the 2014 AHA Information Technology Supplement...
December 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27979558/re-urologist-participation-in-medicare-shared-savings-program-accountable-care-organizations-acos
#11
David F Penson
No abstract text is available yet for this article.
January 2017: Journal of Urology
https://www.readbyqxmd.com/read/27926621/accountable-care-organization-implementation-experiences-and-rural-participation-considerations-for-nurses
#12
Matt Thomas Bagwell, Angeline Bushy, Judith Ortiz
BACKGROUND: Little is known about how accountable care organizations (ACOs) participate with rural health providers. This pilot study examines ACO participation with rural health clinics (RHCs). METHODS: Telephone interviews with 8 ACO administrators were conducted to determine the early implementation experiences of these organizations, and their participation with rural health providers, such as RHCs, using qualitative content analysis, ACO characteristics, and emerging themes from the ACO executive responses was identified...
January 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/27926614/clinical-coordination-in-accountable-care-organizations-a-qualitative-study
#13
Valerie A Lewis, Karen Schoenherr, Taressa Fraze, Aleen Cunningham
BACKGROUND: Accountable care organizations (ACOs) are becoming a common payment and delivery model. Despite widespread interest, little empirical research has examined what efforts or strategies ACOs are using to change care and reduce costs. Knowledge of ACOs' clinical efforts can provide important context for understanding ACO performance, particularly to distinguish arenas where ACOs have and have not attempted care transformation. PURPOSE: The aim of the study was to understand ACOs' efforts to change clinical care during the first 18 months of ACO contracts...
December 6, 2016: Health Care Management Review
https://www.readbyqxmd.com/read/27918403/new-hampshire-nurse-practitioners-take-the-lead-in-forming-an-accountable-care-organization
#14
Wendy L Wright
In 2012, New Hampshire nurse practitioners (NPs), along with Anthem Blue Cross/Blue Shield, formed the first Patient Centered Shared Savings Program in the nation, composed of patients managed by nurse practitioners employed within NP-owned and operated clinics. In this accountable care organization (ACO), NP-attributed patients were grouped into one risk pool. Data from the ACO and the NP risk pool, now in its third year, have produced compelling statistics. Nurse practitioners participating in this program have met or exceeded the minimum scores for 29 quality metrics along with a demonstrated cost-savings in the first 2 years of the program...
January 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/27913910/a-randomized-trial-of-displaying-paid-price-information-on-imaging-study-and-procedure-ordering-rates
#15
Alyna T Chien, Lisa Soleymani Lehmann, Laura A Hatfield, Kate E Koplan, Carter R Petty, Anna D Sinaiko, Meredith B Rosenthal, Thomas D Sequist
BACKGROUND: Prior studies have demonstrated how price transparency lowers the test-ordering rates of trainees in hospitals, and physician-targeted price transparency efforts have been viewed as a promising cost-controlling strategy. OBJECTIVE: To examine the effect of displaying paid-price information on test-ordering rates for common imaging studies and procedures within an accountable care organization (ACO). DESIGN: Block randomized controlled trial for 1 year...
December 2, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27870686/era-of-a-single-population-based-payment-to-a-cancer-center-delivering-the-value-of-interventional-oncology-in-accountable-care-organizations
#16
Jemianne B Jia, Riccardo Lencioni, Howard P Forman, Hyun S Kim
To curtail increasing health care costs, the government has ushered in the era of the Accountable care organization (ACO). The purposes of this review are to evaluate the effects the ACO will have on the practice of interventional oncology and its role in cancer care and to explore methods to assimilate. Proposed action points include integration into the modern-day cancer center, adoption of an outpatient clinic, mandatory performance measures, and workflow and cost analysis. If adaptations are made, interventional oncology can continue its role in cancer treatment, will provide more effective care, and reach more patients in the new ACO...
November 2016: Cancer Journal
https://www.readbyqxmd.com/read/27834253/housing-transportation-and-food-how-acos-seek-to-improve-population-health-by-addressing-nonmedical-needs-of-patients
#17
Taressa Fraze, Valerie A Lewis, Hector P Rodriguez, Elliott S Fisher
Addressing nonmedical needs-such as the need for housing-is critical to advancing population health, improving the quality of care, and lowering the costs of care. Accountable care organizations (ACOs) are well positioned to address these needs. We used qualitative interviews with ACO leaders and site visits to examine how these organizations addressed the nonmedical needs of their patients, and the extent to which they did so. We developed a typology of medical and social services integration among ACOs that disentangles service and organizational integration...
November 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27707589/future-considerations-for-clinical-dermatology-in-the-setting-of-21st-century-american-policy-reform-accountable-care-organizations
#18
Harrison P Nguyen, John S Barbieri, Howard P Forman, Jean L Bolognia, Marta J VanBeek
An Accountable Care Organization (ACO) is a network of providers that collaborates to manage care and is financially incentivized to realize cost savings while also optimizing standards of care. Since its introduction as part of the 2010 Patient Protection and Affordable Care Act, ACOs have grown to include 16% of Medicare beneficiaries and currently represent Medicare's largest payment initiative. Although ACOs are still in the pilot phase with multiple structural models being assessed, incentives are being introduced to encourage specialist participation, and dermatologists will have the opportunity to influence both the cost savings and quality standard aspects of these organizations...
January 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/27704322/an-agent-based-simulation-model-of-patient-choice-of-health-care-providers-in-accountable-care-organizations
#19
Abdullah Alibrahim, Shinyi Wu
Accountable care organizations (ACO) in the United States show promise in controlling health care costs while preserving patients' choice of providers. Understanding the effects of patient choice is critical in novel payment and delivery models like ACO that depend on continuity of care and accountability. The financial, utilization, and behavioral implications associated with a patient's decision to forego local health care providers for more distant ones to access higher quality care remain unknown. To study this question, we used an agent-based simulation model of a health care market composed of providers able to form ACO serving patients and embedded it in a conditional logit decision model to examine patients capable of choosing their care providers...
October 4, 2016: Health Care Management Science
https://www.readbyqxmd.com/read/27702959/acos-holding-commercial-contracts-are-larger-and-more-efficient-than-noncommercial-acos
#20
David Peiris, Madeleine C Phipps-Taylor, Courtney A Stachowski, Lee-Sien Kao, Stephen M Shortell, Valerie A Lewis, Meredith B Rosenthal, Carrie H Colla
Accountable care organizations (ACOs) have diverse contracting arrangements and have displayed wide variation in their performance. Using data from national surveys of 399 ACOs, we examined differences between the 228 commercial ACOs (those with commercial payer contracts) and the 171 noncommercial ACOs (those with only public contracts, such as with Medicare or Medicaid). Commercial ACOs were significantly larger and more integrated with hospitals, and had lower benchmark expenditures and higher quality scores, compared to noncommercial ACOs...
October 1, 2016: Health Affairs
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