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ACO Accountable care organizations

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https://www.readbyqxmd.com/read/29771724/early-impact-of-medicare-accountable-care-organizations-on-inpatient-surgical-spending
#1
Hari Nathan, Jyothi R Thumma, Andrew M Ryan, Justin B Dimick
OBJECTIVE: To evaluate whether hospital participation in accountable care organizations (ACOs) is associated with reduced Medicare spending for inpatient surgery. BACKGROUND: ACOs have proliferated rapidly and now cover more than 32 million Americans. Medicare Shared Savings Program (MSSP) ACOs have shown modest success in reducing medical spending. Whether they have reduced surgical spending remains unknown. METHODS: We used 100% Medicare claims from 2010 to 2014 for patients aged 65 to 99 years undergoing 6 common elective surgical procedures [abdominal aortic aneurysm (AAA) repair, colectomy, coronary artery bypass grafting (CABG), hip or knee replacement, or lung resection]...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29768311/impact-of-provider-participation-in-aco-programs-on-preventive-care-services-patient-experiences-and-health-care-expenditures-in-us-adults-aged-18-64
#2
Young-Rock Hong, Kalyani Sonawane, Samantha Larson, Arch G Mainous, Nicole M Marlow
BACKGROUND: Little is known about the impact of accountable care organization (ACO) on US adults aged 18-64. OBJECTIVES: To examine whether having a usual source of care (USC) provider participating in an ACO affects receipt of preventive care services, patient experiences, and health care expenditures among nonelderly Americans. RESEARCH DESIGN: A cross-sectional analysis of the 2015 Medical Organizations Survey linked with the Medical Expenditure Panel Survey...
May 15, 2018: Medical Care
https://www.readbyqxmd.com/read/29762273/patient-engagement-in-aco-practices-and-patient-reported-outcomes-among-adults-with-co-occurring-chronic-disease-and-mental-health-conditions
#3
Susan L Ivey, Stephen M Shortell, Hector P Rodriguez, Yue Emily Wang
BACKGROUND: Accountable care organizations (ACOs) have increased their use of patient activation and engagement strategies, but it is unknown whether they achieve better outcomes for patients with comorbid chronic physical and mental health conditions. OBJECTIVES: To assess the extent to which practices with patient-centered cultures, greater shared decision-making strategies, and better coordination among team members have better patient-reported outcomes (PROs) for patients with diabetes and/or cardiovascular and comorbid mental health diagnoses...
May 12, 2018: Medical Care
https://www.readbyqxmd.com/read/29749288/changes-in-quality-of-life-among-enrollees-in-hennepin-health-a-medicaid-expansion-aco
#4
Katherine D Vickery, Nathan D Shippee, Laura M Guzman-Corrales, Cindy Cain, Sarah Turcotte Manser, Tom Walton, Jessica Richards, Mark Linzer
Despite limited program evaluations of Medicaid accountable care organizations (ACOs), no studies have examined if cost-saving goals negatively affect quality of life and health care experiences of low-income enrollees. The Hennepin Health ACO uses an integrated care model to address the physical, behavioral, and social needs of Medicaid expansion enrollees. As part of a larger evaluation, we conducted semistructured interviews with 35 primary care using Hennepin Health members enrolled for 2 or more years...
May 1, 2018: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29737573/organizational-attributes-associated-with-medicare-aco-quality-performance
#5
Xi Zhu, Keith Mueller, Huang Huang, Fred Ullrich, Thomas Vaughn, A Clinton MacKinney
PURPOSE: To evaluate associations between geographic, structural, and service-provision attributes of Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) and the ACOs' quality performance. METHODOLOGY: We conducted cross-sectional and longitudinal analyses of ACO quality performance using data from the Centers for Medicare and Medicaid Services and additional sources. The sample included 322 and 385 MSSP ACOs that had successfully reported quality measures in 2014 and 2015, respectively...
May 8, 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/29723553/a-strategic-tension-for-hospitals-moving-upstream-cede-control-but-maintain-accountability
#6
Lauren A Taylor, Caroline Morgan Berchuck, Katherine Gergen Barnett
Health systems are focusing attention on the role that social determinants of health (SDOH) can and should play in health care delivery. This is especially true among accountable care organizations (ACOs) and Medicaid ACOs in particular. In crafting SDOH strategies, senior leadership teams may face an organizational tension in aiming to cede control over dollars, data and patient experience to community-based organizations (CBOs) while also maintaining financial accountability for health outcomes. We review the history of neighborhood health centers (NHCs) in order to foreshadow the types of critiques ACOs are likely to face in working with CBOs...
April 30, 2018: Preventive Medicine
https://www.readbyqxmd.com/read/29720300/chronic-obstructive-pulmonary-disease-and-heart-failure-self-management-kits-for-outpatient-transitions-of-care
#7
Paul Boylan, Tina Joseph, Genevieve Hale, Cynthia Moreau, Matthew Seamon, Renee Jones
OBJECTIVE: To develop heart failure (HF) and chronic obstructive pulmonary disease (COPD) self-management kits in an accountable care organization (ACO) to facilitate patients' self-care and prevent hospital readmissions. SETTING: Pharmacists practice in an outpatient-based ACO. They participate in interprofessional office visits with providers and independently manage maintenance pharmacotherapies. PRACTICE DESCRIPTION: Pharmacists collaborate with an interprofessional team within the ACO including physicians, nurses, case managers, and paramedics...
March 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29624190/hospitalist-value-in-an-aco-world
#8
Jing Li, Mark J Williams
The accountable care organization (ACO) concept is advocated as a promising value-based payment model that could successfully realign the current payment system to financially reward improvements in quality and efficiency. Focusing on the care of hospitalized patients and controlling a substantive portion of variable hospital expenses, hospitalists are poised to play an essential role in system-level transformational change to achieve clinical integration. Especially through hospital and health system quality improvement (QI) initiatives, hospitalists can directly impact and share accountability for measures ranging from care coordination to implementation of evidence-based care and the patient and family caregiver experience...
April 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29595469/assessing-provider-partnerships-for-accountable-care-organizations
#9
David Muhlestein, Katelyn de Lisle, Thomas Merrill
PURPOSE: Understand current provider approaches to the evaluation of various partnerships under accountable care contracts and create a framework to help accountable care organizations (ACOs) better assess their partnerships. DESIGN: Study included (1) an in-depth literature review of materials describing high-value health care organizations as a foundation for draft framework development, (2) an expert panel convened to evaluate the framework and help prioritize provider types to evaluate, and (3) interviews with representatives of ACOs and entities representing various types of health care providers...
March 2018: Managed Care
https://www.readbyqxmd.com/read/29587763/on-designing-of-a-low-leakage-patient-centric-provider-network
#10
Yuchen Zheng, Kun Lin, Thomas White, Jeremy Pickreign, Gigi Yuen-Reed
BACKGROUND: When a patient in a provider network seeks services outside of their community, the community experiences a leakage. Leakage is undesirable as it typically leads to higher out-of-network cost for patient and increases barrier for care coordination, which is particularly problematic for Accountable Care Organization (ACO) as the in-network providers are financially responsible for quality of care and outcome. We aim to design a data-driven method to identify naturally occurring provider networks driven by diabetic patient choices, and understand the relationship among provider composition, patient composition, and service leakage pattern...
March 27, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29557880/association-between-hospital-participation-in-medicare-shared-savings-program-accountable-care-organizations-and-readmission-following-major-surgery
#11
Tudor Borza, Mary K Oerline, Ted A Skolarus, Edward C Norton, Justin B Dimick, Bruce L Jacobs, Lindsey A Herrel, Chad Ellimoottil, John M Hollingsworth, Andrew M Ryan, David C Miller, Vahakn B Shahinian, Brent K Hollenbeck
OBJECTIVE: To evaluate the effect of Medicare Shared Savings Program accountable care organizations (ACOs) on hospital readmission after common surgical procedures. SUMMARY BACKGROUND DATA: Hospital readmissions following surgery lead to worse patient outcomes and wasteful spending. ACOs, and their associated hospitals, have strong incentives to reduce readmissions from 2 distinct Centers for Medicare and Medicaid Services policies. METHODS: We performed a retrospective cohort study using a 20% national Medicare sample to identify beneficiaries undergoing 1 of 7 common surgical procedures-abdominal aortic aneurysm repair, colectomy, cystectomy, prostatectomy, lung resection, total knee arthroplasty, and total hip arthroplasty-between 2010 and 2014...
March 19, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29554179/medicare-accountable-care-organization-enrollment-and-appropriateness-of-cancer-screening
#12
Matthew J Resnick, Amy J Graves, Sunita Thapa, Robert Gambrel, Mark D Tyson, Daniel Lee, Melinda B Buntin, David F Penson
Importance: Despite rapid diffusion of Accountable Care Organizations (ACOs), whether ACO enrollment results in observable changes in cancer screening remains unknown. Objective: To determine whether Medicare Shared Savings Program (MSSP) ACO enrollment changes the appropriateness of screening for breast, colorectal, and prostate cancers. Design, Setting, and Participants: For this population-based analysis of Medicare beneficiaries, we used Medicare data from 2007 through 2014 and evaluated changes in screening associated with ACO enrollment using differences-in-differences (DD) analyses...
March 19, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29520748/do-changes-in-post-acute-care-use-at-hospitals-participating-in-an-accountable-care-organization-spillover-to-all-medicare-beneficiaries
#13
Amol S Navathe, Alexander M Bain, Rachel M Werner
BACKGROUND: While early evidence suggests that Medicare accountable care organizations (ACOs) may reduce post-acute care (PAC) utilization for attributed beneficiaries, whether these effects spill over to all beneficiaries admitted to hospitals participating in ACOs stray is unknown. OBJECTIVE: The objective of this study was to evaluate whether changes in PAC use and Medicare spending spill over to all beneficiaries admitted to hospitals participating in the Medicare Shared Savings Program (MSSP)...
March 8, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29474312/benchmarking-implications-analysis-of-medicare-accountable-care-organizations-spending-level-and-quality-of-care
#14
Young-Rock Hong, Frederick Kates, Soon Ju Song, Nayoung Lee, R Paul Duncan, Nicole M Marlow
Early evidence has shown that Accountable Care Organizations (ACOs) have achieved some success in improving the quality of care and reducing Medicare costs. However, it has been argued that the ACO rewarding model may disproportionately affect relatively low-spending (LS; considered as efficient) organizations that have fewer options to cut unnecessary services compared with high-spending (HS; inefficient) organizations. We conducted a cross-sectional retrospective study to compare ACO financial and quality of care performance between HS-ACO and LS-ACO...
February 16, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29474310/relationship-between-accountable-care-organization-status-and-30-day-hospital-wide-readmissions-are-all-accountable-care-organizations-created-equal
#15
Andrew Mask, Omolola E Adepoju
OBJECTIVE: We compare hospital readmission rates by accountable care organization (ACO) status with national readmission averages, to determine whether ACO affiliation influences 30-day hospital-wide readmission rates. METHODS: Data from the 2015 American Hospital Association Survey of Care Systems and Payment database were merged with Centers for Medicare and Medicaid's 2015 Hospital Compare Deaths and Readmissions data set. A multinomial logistic regression model is used to examine readmission rates, categorized as better, no different, or worse, in comparison to national averages, by ACO status...
February 16, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29420318/disparities-in-rates-of-surgical-intervention-among-racial-and-ethnic-minorities-in-medicare-accountable-care-organizations
#16
Andrew J Schoenfeld, Daniel J Sturgeon, Justin B Dimick, Christopher M Bono, Justin A Blucher, Lauren B Barton, Joel S Weissman, Adil H Haider
OBJECTIVE: To assess the effect of Accountable Care Organizations (ACOs) on the use of surgical services among racial and ethnic minorities. BACKGROUND: Health reform efforts were expected to reduce healthcare disparities. The impact of ACOs on existing disparities in access to surgical care remains unknown. METHODS: We used national Medicare data (2009-2014) to compare rates of surgery among white, African American, Hispanic, and Asian Medicare beneficiaries for coronary artery bypass grafting, colectomy, total hip arthroplasty, hip fracture repair, and lumbar spine surgery...
February 7, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29406837/optimization-of-medication-use-at-accountable-care-organizations
#17
Chrisanne Wilks, Erik Krisle, Kimberly Westrich, Kristina Lunner, David Muhlestein, Robert Dubois
BACKGROUND: Optimized medication use involves the effective use of medications for better outcomes, improved patient experience, and lower costs. Few studies systematically gather data on the actions accountable care organizations (ACOs) have taken to optimize medication use. OBJECTIVES: To (a) assess how ACOs optimize medication use; (b) establish an association between efforts to optimize medication use and achievement on financial and quality metrics; (c) identify organizational factors that correlate with optimized medication use; and (d) identify barriers to optimized medication use...
May 30, 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29401012/the-hidden-roles-that-management-partners-play-in-accountable-care-organizations
#18
Valerie A Lewis, Thomas D'Aunno, Genevra F Murray, Stephen M Shortell, Carrie H Colla
Accountable care organizations (ACOs) are often discussed and promoted as driven by physicians, hospitals, and other health care providers. However, because of the flexible nature of ACO contracts, management organizations may also become partners in ACOs. We used data from 2013-15 on 276 ACOs from the National Survey of Accountable Care Organizations to understand the prevalence of nonprovider management partners' involvement in ACOs, the services these partners provide, and the structure of ACOs that have such partners...
February 2018: Health Affairs
https://www.readbyqxmd.com/read/29393824/strategic-review-process-for-an-accountable-care-organization-and-emerging-accountable-care-best-practices
#19
Sarah J Conway, Sarah Himmelrich, Scott A Feeser, John A Flynn, Steven J Kravet, Jennifer Bailey, Lindsay C Hebert, Susan H Donovan, Sarah G Kachur, Patricia M C Brown, William A Baumgartner, Scott A Berkowitz
Accountable Care Organizations (ACOs), like other care entities, must be strategic about which initiatives they support in the quest for higher value. This article reviews the current strategic planning process for the Johns Hopkins Medicine Alliance for Patients (JMAP), a Medicare Shared Savings Program Track 1 ACO. It reviews the 3 focus areas for the 2017 strategic review process - (1) optimizing care coordination for complex, at-risk patients, (2) post-acute care, and (3) specialty care integration - reviewing cost savings and quality improvement opportunities, associated best practices from the literature, and opportunities to leverage and advance existing ACO and health system efforts in each area...
February 2, 2018: Population Health Management
https://www.readbyqxmd.com/read/29388199/medicare-accountable-care-organizations-of-diverse-structures-achieve-comparable-quality-and-cost-performance
#20
Leeann N Comfort, Stephen M Shortell, Hector P Rodriguez, Carrie H Colla
OBJECTIVE: To examine whether an empirically derived taxonomy of Accountable Care Organizations (ACOs) is associated with quality and spending performance among patients of ACOs in the Medicare Shared Savings Program (MSSP). DATA SOURCES: Three waves of the National Survey of ACOs and corresponding publicly available Centers for Medicare & Medicaid Services performance data for NSACO respondents participating in the MSSP (N = 204); SK&A Office Based Physicians Database from QuintilesIMS...
January 31, 2018: Health Services Research
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