No difference in outcomes for patients with complex medical needs across Medicare ACOs

Aug. 15, 2019

Accountable care organization (ACO)-reported care management and coordination activities were not associated with improved outcomes among patients who were frail or had multiple chronic conditions, according to a study reported and funded by the Agency for Healthcare Quality and Research.

ACOs give health organizations and providers financial incentives to improve care coordination. However, AHRQ reports that the researchers who reviewed survey responses from 244 ACOs with claims data from 1.4 million Medicare patients found patients in the best-performing ACOs for care management and coordination activities did not have different outcomes as measured by hospital readmissions, hospital or emergency department visits, visits for evaluation and management services in outpatient settings, or healthcare spending compared with patients in lower-performing ACOs.

The agency says study findings suggest that health organizations should consider the effectiveness of investing heavily in care coordination activities that are difficult to implement. “Future efforts to care for patients with complex needs should assess whether strategies found to be effective in other settings are being used, and if so, why they fail to meet expectations,” concluded the researchers.

The study, published in JAMA Network Open, is also part of AHRQ’s Comparative Health System Performance Initiative, which was established to study how healthcare systems promote evidence-based practices in delivering care. Core activities include efforts to:

· Develop a data core to systematically track health systems, their characteristics, and their performance on quality and cost outcomes.

· Identify, characterize, and classify the proliferating forms of health systems.

·  Assess the use of PCOR evidence among health systems.

· Evaluate the association between use of PCOR evidence and quality and cost of care.

· Identify characteristics of high-performing health systems, the influence of external environments on high performance and PCOR adoption, and the role of PCOR evidence in these systems.

· Disseminate findings to health system leadership, patients and consumers, policymakers, and payers.