ACOs: Do accountable care organizations work?

Do accountable care organizations (ACOs) work?  That is the question addressed by this large-scale study of Medicare patients who were cared for by the newly established Pioneer ACOs in 2012 and 2013 compared to a control group.  The authors, who are with the Centers for Medicare & Medicaid Services (CMS), found that:

• Costs for both groups increased in 2012 and 2013, but increased less for the ACO patients than for the control group
• Inpatient hospital utilization was lower for the ACO patients (which was a key factor responsible for the lower rate of increase in costs)
• Readmission rates were similar
• There was a higher rate of physician follow-up visits after hospital discharge for the ACO patients

The authors conclude: “In the first 2 years of the Pioneer ACO Model, beneficiaries aligned with Pioneer ACOs … exhibited smaller increases in total Medicare expenditures and differential reductions in utilization of different health services, with little difference in patient experience.”

WHY IS THIS IS AN IMPORTANT STUDY?  Large scale study involving millions of patients — authoritative federal agency source — fundamental issues related to the reshaping of the American health care delivery system.

Source: Nyweide, D.J., Lee, W., and others. (2015, May 4). Association of pioneer accountable care organizations vs traditional Medicare fee for service with spending, utilization, and patient experience. JAMA. Retrieved from http://jama.jamanetwork.com/article.aspx?articleid=2290608 

There are two commentaries on this article:

• McClellan, M. (2015, May 4). Accountable care organizations and evidence-based payment reform. JAMA. Retrieved from http://jama.jamanetwork.com/article.aspx?articleid=2290607
• Casalino, L.P. (2015, May 4). Pioneer accountable care organizations: traversing rough country. JAMA. Retrieved from http://jama.jamanetwork.com/article.aspx?articleid=2290606  Posted by AHA Resource Center (312) 422-2050, rc@aha.org