Hospital participation in ACOs associated with other value-based program improvement

Area of Science:

• Healthcare Management
• Health Economics
• Quality Improvement

Background:

• Accountable Care Organizations (ACOs) aim to improve quality and reduce costs.
• Value-Based Purchasing (VBP) programs incentivize healthcare providers for quality and efficiency.

Purpose of the Study:

• To analyze the impact of hospital participation in ACOs on performance in Medicare VBP programs.
• To compare outcomes in the Hospital Value-Based Purchasing Program (HVBP), Hospital Readmissions Reduction Program (HRRP), and Hospital-Acquired Conditions (HAC) Reduction Program.

Main Methods:

• Descriptive comparison of VBP performance between hospital ACOs and non-ACO hospitals.
• Longitudinal analysis of hospitals that joined ACOs during the study period.
• Utilized VBP performance data and ACO participation data.

Main Results:

• In fiscal year 2016, hospital ACOs outperformed non-ACO hospitals in HRRP, but not in HVBP or HAC Reduction Programs.
• Longitudinal analysis indicated improving HRRP performance for hospitals joining ACOs.
• HVBP performance showed inconsistent year-over-year results for hospitals joining ACOs.

Conclusions:

• Hospital ACO participation does not consistently correlate with improved performance across all Medicare VBP programs.
• Organizations must develop tailored strategies for ACOs and VBP programs due to differing objectives.