ACOs serving high proportions of minority patients lag in quality performance

January 20, 2017

New research by The Dartmouth Institute finds that Accountable Care Organizations (ACOs) serving a high proportion of minority patients performed significantly worse on many quality-of-care measures than other ACOs. While previous research has shown ACOs have improved quality of care during the first three years of performance, little was known about the impact ACOs and similar payment reforms are having on existing racial and ethnic health disparities.

The study, led by The Dartmouth Institute assistant professor Valerie Lewis, PhD, and recently published in Health Affairs, used data from Medicare and from The Dartmouth Institute's Survey of Accountable Care Organizations to compare the performance of ACOs in Medicare's Shared Savings Program.

Key findings of The Commonwealth Fund supported study include: To address the performance gap and encourage participation in the Medicare Shared Savings Program, the researchers suggest three possible remedies: additional risk adjustment in performance assessment, taking into account socio-economic characteristics of patients; re-examining financial incentives to reward relative improvement rather than overall performance; additional supports or resources that would help ACOs that serve a high proportion of at-risk or disadvantaged patients improve their quality performance.
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To read the full study and learn more about The Dartmouth Institute's latest ACO research: http://tdi.dartmouth.edu/research/evaluating/health-system-focus/accountable-care-organizations/research/latest-aco-publications

The Dartmouth Institute for Health Policy & Clinical Practice

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