Two recent studies will likely serve to boost accountable care organizations (ACOs).
Related: Dartmouth drops out of ACO program
A team of researchers from Harvard Medical School published a study in JAMA Internal Medicine which shows that a Medicare ACO pilot undertaken as part of the Affordable Care Act, the Medicare Shared Savings program, resulted in a 9 percent decrease in spending following acute medical care, such as operations or treatment for serious illness.
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Most importantly, the decrease in spending took place "without ostensible deterioration in quality of care" concluded the researchers.
An important caveat that skeptics of ACOs will be sure to point out is that the Medicare Shared Savings program is voluntary. It is not therefore clear to how ACOs would impact the overall program if they become mandatory.
ACOs are one of a number of ways that the federal government has sought to reduce Medicare spending and chip away at the fee-for-service payment model. Incoming Secretary of Health and Human Services Tom Price has been a proponent of ACOs, although he has insisted that they should remain voluntary.
Another study published in JAMA examined the impact of ACOs on Medicaid programs in Colorado and Oregon. The two programs were similar but distinct.
Oregon used a $1.9 billion federal grant to put its Medicaid beneficiaries into one of 16 coordinated care organizations that cared for patients within a defined budget.
Colorado began its program a year earlier and created seven organizations by region aimed at providing coordinated care to patients, including by directing them to other community resources outside of the health care sector.
Past studies have suggested hospitals often struggle to produce better health outcomes for low-income patients because of the barriers to consistent treatment that the poor encounter, such as inability to fill prescriptions due to cost or lack of transportation, poor nutrition and myriad poverty-related issues.
Therefore, having health care services for the poor, such as Medicaid, collaborate with other social services is increasingly regarded as key to more effectively and efficiently treating low-income patients.
In both cases, the study finds, ACOs were able to reduce spending without reducing the quality of care for Medicaid patients.
In an article accompanying the study's release, chief study author Dr. Carrie Colla writes that ACOs show promise not just because they are cheaper, but because the collaborative approach between providers appears to make patients happier with their care.
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