Medicare Shared Savings Program ACO network comprehensiveness and patient panel stability.

Area of Science:

• Health Services Research
• Healthcare Policy
• Population Health Management

Background:

• The Medicare Shared Savings Program (MSSP) faces challenges with unpredictable patient attribution methodologies.
• Accountable Care Organizations (ACOs) require stable patient panels for effective value-based care initiatives.

Purpose of the Study:

• To investigate the association between ACO network comprehensiveness and the stability of Medicare beneficiary attribution.
• To assess the impact of network comprehensiveness on patient assignment stability within MSSP ACOs.

Main Methods:

• A beneficiary-level logistic regression model was employed to analyze data from 2013-2014 Medicare fee-for-service files.
• Network comprehensiveness was measured using 2013 provider contracts, linked to beneficiary attribution and market-level data.

Main Results:

• 84.38% of beneficiaries maintained stable attribution to the same ACO over the study period.
• A 0.10 increase in network comprehensiveness score correlated with a 4.5% higher likelihood of stable patient attribution (P = .001).
• Patient panel stability was significantly associated with improved diabetes and hypertension control, timely access to care, and health education delivery.

Conclusions:

• The contracted provider network's comprehensiveness in MSSP ACOs is a significant factor in year-to-year patient assignment stability.
• Stable patient panels may facilitate improved longitudinal management of chronic conditions.