The Effects of Medicare Accountable Organizations on Inpatient Mortality Rates
Studies have linked Accountable Care Organizations (ACOs) to improved primary care, but there is little research on how ACOs affect care in other settings. We examined whether Medicare ACOs have improved hospital quality of care, specifically focusing on preventable inpatient mortality. We used 2008...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2018-09-01
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| Series: | Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| Online Access: | https://doi.org/10.1177/0046958018800092 |
| _version_ | 1819140701568368640 |
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| author | Eli Cutler PhD Zeynal Karaca PhD Rachel Henke PhD Michael Head MS Herbert S. Wong PhD |
| author_facet | Eli Cutler PhD Zeynal Karaca PhD Rachel Henke PhD Michael Head MS Herbert S. Wong PhD |
| author_sort | Eli Cutler PhD |
| collection | DOAJ |
| description | Studies have linked Accountable Care Organizations (ACOs) to improved primary care, but there is little research on how ACOs affect care in other settings. We examined whether Medicare ACOs have improved hospital quality of care, specifically focusing on preventable inpatient mortality. We used 2008-2014 Healthcare Cost and Utilization Project hospital discharge data from 34 states’ Medicare ACO and non-ACO hospitals in conjunction with data from the American Hospital Association Annual Survey and the Survey of Care Systems and Payment. We estimated discharge-level logistic regression models that measured the relationship between ACO affiliation and mortality following admissions for acute myocardial infarction, abdominal aortic aneurysm (AAA) repair, coronary artery bypass grafting, and pneumonia, controlling for patient demographic mix, hospital, and year. Our results suggest that, on average, Medicare ACO hospitals are not associated with improved mortality rates for the studied IQI conditions. Stakeholders may potentially consider providing ACOs with incentives or designing new programs for ACOs to target inpatient mortality reductions. |
| first_indexed | 2024-12-22T11:42:44Z |
| format | Article |
| id | doaj.art-3c51ad4380b44195880c9e718f67989b |
| institution | Directory Open Access Journal |
| issn | 0046-9580 1945-7243 |
| language | English |
| last_indexed | 2024-12-22T11:42:44Z |
| publishDate | 2018-09-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| spelling | doaj.art-3c51ad4380b44195880c9e718f67989b2022-12-21T18:27:13ZengSAGE PublishingInquiry: The Journal of Health Care Organization, Provision, and Financing0046-95801945-72432018-09-015510.1177/0046958018800092The Effects of Medicare Accountable Organizations on Inpatient Mortality RatesEli Cutler PhD0Zeynal Karaca PhD1Rachel Henke PhD2Michael Head MS3Herbert S. Wong PhD4IBM Watson Health, Cambridge, MA, USAU.S. Department of Health and Human Services, Agency for Healthcare Research and Quality, Rockville, MD, USAIBM Watson Health, Cambridge, MA, USAIBM Watson Health, Cambridge, MA, USAU.S. Department of Health and Human Services, Agency for Healthcare Research and Quality, Rockville, MD, USAStudies have linked Accountable Care Organizations (ACOs) to improved primary care, but there is little research on how ACOs affect care in other settings. We examined whether Medicare ACOs have improved hospital quality of care, specifically focusing on preventable inpatient mortality. We used 2008-2014 Healthcare Cost and Utilization Project hospital discharge data from 34 states’ Medicare ACO and non-ACO hospitals in conjunction with data from the American Hospital Association Annual Survey and the Survey of Care Systems and Payment. We estimated discharge-level logistic regression models that measured the relationship between ACO affiliation and mortality following admissions for acute myocardial infarction, abdominal aortic aneurysm (AAA) repair, coronary artery bypass grafting, and pneumonia, controlling for patient demographic mix, hospital, and year. Our results suggest that, on average, Medicare ACO hospitals are not associated with improved mortality rates for the studied IQI conditions. Stakeholders may potentially consider providing ACOs with incentives or designing new programs for ACOs to target inpatient mortality reductions.https://doi.org/10.1177/0046958018800092 |
| spellingShingle | Eli Cutler PhD Zeynal Karaca PhD Rachel Henke PhD Michael Head MS Herbert S. Wong PhD The Effects of Medicare Accountable Organizations on Inpatient Mortality Rates Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| title | The Effects of Medicare Accountable Organizations on Inpatient Mortality Rates |
| title_full | The Effects of Medicare Accountable Organizations on Inpatient Mortality Rates |
| title_fullStr | The Effects of Medicare Accountable Organizations on Inpatient Mortality Rates |
| title_full_unstemmed | The Effects of Medicare Accountable Organizations on Inpatient Mortality Rates |
| title_short | The Effects of Medicare Accountable Organizations on Inpatient Mortality Rates |
| title_sort | effects of medicare accountable organizations on inpatient mortality rates |
| url | https://doi.org/10.1177/0046958018800092 |
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