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Medicare ACO Program Savings Not Tied To Preventable Hospitalizations Or Concentrated Among High-Risk Patients.

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  • Additional Information
    • Subject Terms:
    • NAICS/Industry Codes:
      621494 Community health centres
      621499 All other out-patient care centres
      621498 All Other Outpatient Care Centers
      923130 Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs)
      541910 Marketing Research and Public Opinion Polling
    • Abstract:
      It has been widely assumed that better management and coordination of care for chronic conditions and high-risk patients would be the leading mechanisms for achieving savings in accountable care organizations (ACOs), specifically by reducing acute care needs through enhanced outpatient and preventive care. We examined the extent to which changes in spending and hospitalizations for ACO patients in the Medicare Shared Savings Program (MSSP) have been consistent with this expectation. By 2014, participation in the MSSP was associated with significant reductions in total Medicare fee-for-service spending for ACO patients but with proportionately smaller reductions in hospitalizations and some increases in hospitalizations for ambulatory care--sensitive conditions. In addition, spending reductions were not clearly concentrated among high-risk patients: Reductions for those patients accounted for only 38 percent of the total reduction among ACOs entering the MSSP in 2012, and reductions among 2013 MSSP entrants were almost entirely concentrated among lower-risk patients. These findings suggest that, on average, care coordination and management efforts focused on ambulatory care--sensitive conditions and high-risk patients have not been the major drivers of early savings in the MSSP. [ABSTRACT FROM AUTHOR]
    • Abstract:
      Copyright of Health Affairs is the property of Project HOPE/HEALTH AFFAIRS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
    • Author Affiliations:
      1Warren Alpert Foundation Professor of Health Care Policy in the Department of Health Care Policy, Harvard Medical School, in Boston, Massachusetts
      2Leonard D. Schaeffer Professor of Health Care Policy in the Department of Health Care Policy, Harvard Medical School
      3Professor of health care policy in the Department of Health Care Policy, Harvard Medical School
    • ISSN:
      0278-2715
    • Accession Number:
      10.1377/hlthaff.2017.0814
    • Accession Number:
      126780659
  • Citations
    • ABNT:
      MCWILLIAMS, J. M.; CHERNEW, M. E.; LANDON, B. E. Medicare ACO Program Savings Not Tied To Preventable Hospitalizations Or Concentrated Among High-Risk Patients. Health Affairs, [s. l.], v. 36, n. 12, p. 2085–2093, 2017. DOI 10.1377/hlthaff.2017.0814. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=126780659&custid=s8280428. Acesso em: 7 jul. 2020.
    • AMA:
      McWilliams JM, Chernew ME, Landon BE. Medicare ACO Program Savings Not Tied To Preventable Hospitalizations Or Concentrated Among High-Risk Patients. Health Affairs. 2017;36(12):2085-2093. doi:10.1377/hlthaff.2017.0814.
    • AMA11:
      McWilliams JM, Chernew ME, Landon BE. Medicare ACO Program Savings Not Tied To Preventable Hospitalizations Or Concentrated Among High-Risk Patients. Health Affairs. 2017;36(12):2085-2093. doi:10.1377/hlthaff.2017.0814
    • APA:
      McWilliams, J. M., Chernew, M. E., & Landon, B. E. (2017). Medicare ACO Program Savings Not Tied To Preventable Hospitalizations Or Concentrated Among High-Risk Patients. Health Affairs, 36(12), 2085–2093. https://doi.org/10.1377/hlthaff.2017.0814
    • Chicago/Turabian: Author-Date:
      McWilliams, J. Michael, Michael E. Chernew, and Bruce E. Landon. 2017. “Medicare ACO Program Savings Not Tied To Preventable Hospitalizations Or Concentrated Among High-Risk Patients.” Health Affairs 36 (12): 2085–93. doi:10.1377/hlthaff.2017.0814.
    • Harvard:
      McWilliams, J. M., Chernew, M. E. and Landon, B. E. (2017) ‘Medicare ACO Program Savings Not Tied To Preventable Hospitalizations Or Concentrated Among High-Risk Patients’, Health Affairs, 36(12), pp. 2085–2093. doi: 10.1377/hlthaff.2017.0814.
    • Harvard: Australian:
      McWilliams, JM, Chernew, ME & Landon, BE 2017, ‘Medicare ACO Program Savings Not Tied To Preventable Hospitalizations Or Concentrated Among High-Risk Patients’, Health Affairs, vol. 36, no. 12, pp. 2085–2093, viewed 7 July 2020, .
    • MLA:
      McWilliams, J.Michael, et al. “Medicare ACO Program Savings Not Tied To Preventable Hospitalizations Or Concentrated Among High-Risk Patients.” Health Affairs, vol. 36, no. 12, Dec. 2017, pp. 2085–2093. EBSCOhost, doi:10.1377/hlthaff.2017.0814.
    • Chicago/Turabian: Humanities:
      McWilliams, J. Michael, Michael E. Chernew, and Bruce E. Landon. “Medicare ACO Program Savings Not Tied To Preventable Hospitalizations Or Concentrated Among High-Risk Patients.” Health Affairs 36, no. 12 (December 2017): 2085–93. doi:10.1377/hlthaff.2017.0814.
    • Vancouver/ICMJE:
      McWilliams JM, Chernew ME, Landon BE. Medicare ACO Program Savings Not Tied To Preventable Hospitalizations Or Concentrated Among High-Risk Patients. Health Affairs [Internet]. 2017 Dec [cited 2020 Jul 7];36(12):2085–93. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=126780659&custid=s8280428