ACOs serving high proportions of minority patients lag in quality performance
January 20, 2017New 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:
- On average, 18% of patients in ACOs were members of minority groups (10.2% black, 2.6% Hispanic, 2.4% Asian, .02% Native American, and 2.4% of another race).
- Compared with patients in other ACOs, patients in ACOs with a high proportion of minority patients tended to be younger than 65, dually eligible for Medicare and Medicaid, disabled, female, and to have end-stage renal disease.
- Having a higher proportion of minority patients was associated with worse performance on 25 of 36 measures (adjusted). Providers with a high proportion of minority patients had lower overall quality composite scores, compared to other providers. (The measure is used by CMS to determine the share of generated savings that an ACO will receive.)
- ACOs with a high proportion of minority patients did not typically "catch up" over time. The association between proportion of minority patients and quality performance was consistent between the first and second years of the ACO programs.
- There were no significant differences between ACOs with higher proportions of minority patients and others in terms of provider composition and capabilities. ACOs with higher proportions of minority patients were significantly less likely than other ACOs to offer the following services: routine specialty care, outpatient rehabilitation, pediatric care, and palliative and hospice care.
-end-
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-publicationsThe Dartmouth Institute for Health Policy & Clinical Practice
Related Medicare Articles from Brightsurf:
Falling Medicare reimbursement rates for orthopaedic trauma
The amount Medicare reimburses for orthopaedic trauma surgery has fallen by nearly one-third over the past two decades, reports a study in the Journal of Orthopaedic Trauma.
Medicare coverage varies for transgender hormone therapies
A new study has shown substantial variability in access to guideline-recommended hormone therapies for older transgender individuals insured through Medicare.
Medicare changes may increase access to TAVR
The number of hospitals providing TAVR could double with changes to Medicare requirements.
Inequitable medicare reimbursements threaten care of most vulnerable
Hospitals, doctors and Medicare Advantage insurance plans that care for some of the most vulnerable patients are not reimbursed fairly by Medicare, according to recent findings in JAMA.
Medicare may overpay for many surgical procedures
For most surgical procedures, Medicare provides physicians a single bundled payment that covers both the procedure and related postoperative care over a period of up to 90 days.
Only 1 in 4 Medicare patients participate in cardiac rehabilitation
Only about 24% of Medicare patients who could receive outpatient cardiac rehabilitation participate in the program.
How common is food insecurity among Medicare enrollees?
Nearly 1 in 10 Medicare enrollees age 65 and over and 4 in 10 enrollees younger than 65 with long-term disabilities experience food insecurity.
Medicare for All unlikely to cause surge in hospital use: Harvard study
Despite some analysts' claims that Medicare for All would cause a sharp increase in health care utilization, a new study finds the two biggest coverage expansions in US history -- Medicare and the ACA -- caused no net increase in hospital use.
Critical heart drug too pricey for some Medicare patients
An effective drug to treat chronic heart failure may cost too much for senior citizens with a standard Medicare Part D drug plan, said a study co-authored by a John A.
Research suggests strategy for more equitable Medicare reimbursement
Those who were enrolled in both Medicare and Medicaid were sicker, had more cognitive impairments and difficulty functioning, and needed more social support than those who were not enrolled in both government programs, Saint Louis University research found.
Read More: Medicare News and Medicare Current Events
The amount Medicare reimburses for orthopaedic trauma surgery has fallen by nearly one-third over the past two decades, reports a study in the Journal of Orthopaedic Trauma.
Medicare coverage varies for transgender hormone therapies
A new study has shown substantial variability in access to guideline-recommended hormone therapies for older transgender individuals insured through Medicare.
Medicare changes may increase access to TAVR
The number of hospitals providing TAVR could double with changes to Medicare requirements.
Inequitable medicare reimbursements threaten care of most vulnerable
Hospitals, doctors and Medicare Advantage insurance plans that care for some of the most vulnerable patients are not reimbursed fairly by Medicare, according to recent findings in JAMA.
Medicare may overpay for many surgical procedures
For most surgical procedures, Medicare provides physicians a single bundled payment that covers both the procedure and related postoperative care over a period of up to 90 days.
Only 1 in 4 Medicare patients participate in cardiac rehabilitation
Only about 24% of Medicare patients who could receive outpatient cardiac rehabilitation participate in the program.
How common is food insecurity among Medicare enrollees?
Nearly 1 in 10 Medicare enrollees age 65 and over and 4 in 10 enrollees younger than 65 with long-term disabilities experience food insecurity.
Medicare for All unlikely to cause surge in hospital use: Harvard study
Despite some analysts' claims that Medicare for All would cause a sharp increase in health care utilization, a new study finds the two biggest coverage expansions in US history -- Medicare and the ACA -- caused no net increase in hospital use.
Critical heart drug too pricey for some Medicare patients
An effective drug to treat chronic heart failure may cost too much for senior citizens with a standard Medicare Part D drug plan, said a study co-authored by a John A.
Research suggests strategy for more equitable Medicare reimbursement
Those who were enrolled in both Medicare and Medicaid were sicker, had more cognitive impairments and difficulty functioning, and needed more social support than those who were not enrolled in both government programs, Saint Louis University research found.
Read More: Medicare News and Medicare Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.