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Medicare Accountable Care Organizations: Quality Performance by Geographic Categories.

Xi Zhu, Keith Mueller, Thomas Vaughn

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    Rural Medicare Accountable Care Organizations (ACOs) outperformed urban ones in key quality areas in 2014. Both rural and urban ACOs demonstrated improved quality performance from 2014 to 2015.

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    Area of Science:

    • Health Services Research
    • Healthcare Policy
    • Rural Health

    Background:

    • Medicare Accountable Care Organizations (ACOs) aim to improve healthcare quality and reduce costs.
    • Understanding geographic variations in ACO performance is crucial for policy development.
    • Previous research by the RUPRI Center has analyzed ACO performance in rural areas.

    Purpose of the Study:

    • To analyze the performance of Medicare Shared Savings ACOs based on their level of rural presence.
    • To compare ACO performance across four quality measure domains and overall quality scores.
    • To identify differences in quality performance between rural and urban ACOs.

    Main Methods:

    • Analysis of Medicare Shared Savings ACO performance data.
    • Comparison of quality measure domains and overall quality scores.
    • Stratification of ACOs by geographic categories, including rural and urban counties.

    Main Results:

    • Rural ACOs demonstrated superior performance in Care Coordination/Patient Safety, Preventive Health, and At-Risk Population domains in 2014.
    • Urban ACOs showed better performance in the Patient/Caregiver Experience domain in 2014.
    • Quality performance improved across all geographic categories of ACOs between 2014 and 2015.

    Conclusions:

    • ACOs in rural counties exhibit strengths in specific quality domains compared to urban counterparts.
    • Patient and caregiver experience may be an area where urban ACOs currently excel.
    • Continuous quality improvement is evident across all ACOs regardless of geographic location.