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Organizational Attributes Associated With Medicare ACO Quality Performance.
Xi Zhu1, Keith Mueller1, Huang Huang1
1Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, Iowa.
Summary
Rural Accountable Care Organizations (ACOs) show comparable quality performance to non-rural ACOs. Key factors for better Medicare Shared Savings Program (MSSP) ACO quality include hospital sponsorship, larger patient panels, and strong post-hospitalization follow-up.
Area of Science:
- Health Services Research
- Healthcare Management
- Quality Improvement
Background:
- Accountable Care Organizations (ACOs) aim to improve healthcare quality and reduce costs.
- The Medicare Shared Savings Program (MSSP) incentivizes ACOs to achieve these goals.
- Understanding factors influencing ACO quality performance is crucial for program success.
Purpose of the Study:
- To examine the relationship between ACO characteristics (geographic, structural, service-provision) and their quality performance within the MSSP.
- To identify specific attributes associated with higher quality outcomes in MSSP ACOs.
Main Methods:
- Cross-sectional and longitudinal analyses were performed.
- Data from the Centers for Medicare and Medicaid Services (CMS) and other sources were utilized.
- Quality performance of 322 (2014) and 385 (2015) MSSP ACOs was assessed.
Main Results:
- Rural ACOs demonstrated quality scores comparable to those in other geographic areas after adjustments.
- ACOs with hospital-system sponsorship, larger beneficiary populations, and higher post-hospitalization follow-up rates achieved superior quality performance.
- No significant difference in average quality was found between rural and non-rural ACOs when controlling for structural and service factors.
Conclusions:
- Geographic location (rural vs. non-rural) is not a significant differentiator of ACO quality performance in the MSSP.
- Hospital-system sponsorship, beneficiary panel size, and post-hospitalization follow-up rates are positively associated with improved MSSP ACO quality.
- These findings highlight actionable strategies for enhancing ACO quality performance.
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