Quality of Care Improves for Patients with Diabetes in Medicare Shared Savings Accountable Care Organizations: Organizational Characteristics Associated with Performance

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Citation

Fraze, Taressa K.; Lewis, Valerie A.; Tierney, Emily; & Colla, Carrie H. (2018). Quality of Care Improves for Patients with Diabetes in Medicare Shared Savings Accountable Care Organizations: Organizational Characteristics Associated with Performance. Population Health Management, 21(5), 401-408. PMCID: PMC6425920

Abstract

Accountable care organizations (ACOs), a primary care-centric delivery and payment model, aim to promote integrated population health, which may improve care for those with chronic conditions such as diabetes. Research has shown that, overall, the ACO model is effective at reducing costs, but there is substantial variation in how effective different types of ACOs are at impacting costs and improving care delivery. This study examines how ACO organizational characteristics - such as composition, staffing, care management, and experiences with health reform - were associated with quality of care delivered to patients with diabetes. Secondary data were analyzed retrospectively to examine Medicare Shared Savings Program (MSSP) ACOs' performance on diabetes metrics in the first 2 years of ACO contracts. Ordinary least squares was used to analyze 162 MSSP ACOs with publicly available performance data and the National Survey of ACOs. ACOs improved performance significantly for patients with diabetes between contract years 1 and 2. In year 1, also having a private payer contract and an increased number of services within the ACO were positively associated with performance, while having a community health center or a hospital were negatively associated with performance. Better performance in year 1 was negatively associated with improved performance in year 2. This study found that ACOs substantively improved diabetes management within initial contract years. ACOs may need different types of support throughout their contracts to ensure continued improvements in performance.

URL

http://dx.doi.org/10.1089/pop.2017.0102

Reference Type

Journal Article

Year Published

2018

Journal Title

Population Health Management

Author(s)

Fraze, Taressa K.
Lewis, Valerie A.
Tierney, Emily
Colla, Carrie H.

Article Type

Regular

PMCID

PMC6425920

Data Set/Study

Centers for Medicare and Medicaid Services
National Survey of ACOs

Continent/Country

United States

State

Nonspecific