Related Experiment Video
Updated: Jan 25, 2026
04:24
A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
12.3K
Why Do Accountable Care Organizations Leave The Medicare Shared Savings Program?
William K Bleser1, Robert S Saunders2, David B Muhlestein3
1William K. Bleser ( william.bleser@duke.edu ) is a research associate at the Duke-Margolis Center for Health Policy, Duke University, in Washington, D.C.
Health Affairs (Project Hope)
|May 7, 2019
Summary
Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program (MSSP) are more likely to survive if they achieve shared savings, coordinate care, and have higher benchmarks. Policy changes may require more preparation time for ACOs facing downside risk.
Area of Science:
- Health Services Research
- Health Policy
- Healthcare Management
Background:
- Accountable Care Organizations (ACOs) are crucial for healthcare reform, aiming to reduce costs and improve quality.
- Understanding factors influencing ACO survival is vital for program sustainability and effectiveness.
Purpose of the Study:
- To identify key factors associated with the survival of ACOs participating in the Medicare Shared Savings Program (MSSP).
- To inform policy decisions regarding ACO program design and support.
Main Methods:
- Analysis of data from 624 ACOs in the MSSP between 2013 and 2017 (1,849 ACO-years).
- Examined associations between various organizational, financial, and market characteristics and ACO survival rates.
Main Results:
- ACO exits decreased after the third year.
- Factors associated with longer survival included shared-savings bonus achievement, care coordination, higher financial benchmarks, market cost growth, lower-risk patients, and upside-only risk contracts.
- Quality scores and organizational traits did not significantly impact survival.
Conclusions:
- Diverse organizations and markets can succeed in the MSSP.
- Current policy changes may necessitate longer preparation periods for ACOs to manage downside risk.
- Policy makers should enhance support for ACOs, particularly those serving higher-risk populations, and refine benchmarking to ensure fairness across different market cost growth levels.
Related Concept Videos
02:14Leaving Groups
9.6K
The nature of leaving groups strongly influences the outcome of a nucleophilic substitution reaction.
In general, in a nucleophilic substitution reaction, a nucleophile displaces a functional group, called the leaving group, from the substrate to give a substituted product. A leaving group departs the substrate molecule through heterolytic cleavage, taking the pair of electrons with it to become a relatively stable weak base in the form of an anion or a neutral molecule.
In a...
In general, in a nucleophilic substitution reaction, a nucleophile displaces a functional group, called the leaving group, from the substrate to give a substituted product. A leaving group departs the substrate molecule through heterolytic cleavage, taking the pair of electrons with it to become a relatively stable weak base in the form of an anion or a neutral molecule.
In a...
9.6K
01:09Levels of Organization
139.4K
Biological organization is the classification of biological structures, ranging from atoms at the bottom of the hierarchy to the Earth's biosphere. Each level of the hierarchy represents an increase in complexity that builds upon the previous level.
Molecules Are Composed of Atoms, and Biomolecules Are Assembled from Molecules:
The most basic levels include atoms, molecules, and biomolecules. Atoms, the smallest unit of ordinary matter, are composed of a nucleus and electrons. Molecules...
Molecules Are Composed of Atoms, and Biomolecules Are Assembled from Molecules:
The most basic levels include atoms, molecules, and biomolecules. Atoms, the smallest unit of ordinary matter, are composed of a nucleus and electrons. Molecules...
139.4K
01:09Accountability and Responsibility of a Nurse II
1.1K
Professional accountability in nursing is a multifaceted concept that encompasses professional ethics, legal standards, and employment expectations. This framework ensures that nurses maintain and elevate the quality of care while upholding the values of their profession. It compels them to treat patients, families, and colleagues with respect, compassion, and integrity.
For example, a nurse demonstrating respect and compassion might listen attentively to a patient's concerns, provide...
For example, a nurse demonstrating respect and compassion might listen attentively to a patient's concerns, provide...
1.1K
01:30Accountability and Responsibility of a Nurse I
2.9K
Accountability in nursing is a fundamental principle that underscores the obligation of nurses to take responsibility for their actions and answer for any errors or omissions in patient care. This principle is grounded in the professional, legal, and ethical frameworks that shape nursing practice. For instance, nurses must adhere to all relevant laws, regulations, and practice standards, including guidelines set forth by nursing boards and professional bodies, to ensure their actions comply...
2.9K
01:21Interdisciplinary Care: The Health Care Team-I
2.6K
An interdisciplinary team includes many healthcare professionals working together and utilizing their skills, knowledge, and expertise to provide holistic and quality patient care.
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution...
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution...
2.6K
01:18Interdisciplinary Care: The Health Care Team-II
2.2K
An interdisciplinary team includes many healthcare professionals working together and utilizing their skills, knowledge, and expertise to provide holistic and quality patient care. Here are a few more healthcare professionals.
Physical Therapist
A physical therapist (PT) aims to restore function or prevent additional impairment in a patient following an injury or disease. Massage, heat, cold, water, sonar waves, exercises, and electrical stimulation are some treatments used by PTs to treat...
Physical Therapist
A physical therapist (PT) aims to restore function or prevent additional impairment in a patient following an injury or disease. Massage, heat, cold, water, sonar waves, exercises, and electrical stimulation are some treatments used by PTs to treat...
2.2K