Accountable Care Organizations and Health Disparities of Rural Latinos: A Longitudinal Analysis

Area of Science:

• Health Services Research
• Health Disparities Research
• Rural Health

Background:

• Diabetes disproportionately affects rural Latino older adults, leading to higher hospitalization rates.
• Understanding factors that reduce health disparities in this population is crucial for equitable care.
• Rural Health Clinics (RHCs) play a significant role in serving rural populations, including Latinos.

Purpose of the Study:

• To analyze changes in diabetes-related hospitalization rates among rural Latino older adults compared to White counterparts.
• To identify factors, including accountable care organization (ACO) participation, associated with reduced diabetes hospitalization disparities.

Main Methods:

• Analysis of Medicare beneficiary data for Latino patients served by RHCs over an 8-year period.
• Difference-of-means test to compare disparities in pre-ACO (2008-2011) and post-ACO (2012-2015) periods.
• Multiple regression analyses to assess the relationship between ACO participation and reduced disparities.

Main Results:

• A statistically significant decrease in diabetes-related hospitalization disparities between Latino and White patients was observed over time.
• Moderate evidence suggested consistent ACO participation was associated with lower health disparities (P=0.0525).
• The association between ACO participation and reduced disparities was not significant after covariate balancing, and causality could not be established.

Conclusions:

• Diabetes-related hospitalization disparities for rural Latino older adults decreased significantly over the study period.
• While ACO participation showed a potential association with reduced disparities, further research is needed to establish causality.
• ACOs should prioritize monitoring and ensuring equitable care provision for vulnerable populations, including rural Latinos.