If the jury is still out on ACOs, a study by Harvard researchers published in today’s New England Journal of Medicine could be a sign that the verdict will ultimately be that they work.
Judging by these results, ACOs seem effective at reducing health spending, albeit by a modest amount, but may not make much of a difference when it comes to performance measures like hospital readmission.
CMS has previously reported that Pioneer ACOs are a spending reduction success story and save the Medicare program money.
What’s new here is that an independent group of researchers, using some rigorous research methods, have arrived at pretty much the same conclusion.
The Harvard researchers also supplied some details and nuances. Here are a few of them:
The overall finding of the study was that Pioneer ACOs as a group program reduced health care spending by 1.2%, or by $29.20 per beneficiary per quarter, during the first year of the program.
That modest but statistically significant decrease translates into $118 million less in Medicare spending when the spending reductions by all 32 Pioneer ACOs savings are added up. That total exceeds the $76 million in bonuses paid by CMS to the Pioneers ACOs by $42 million, the Harvard researchers pointed out. In other words, it was an okay deal for taxpayers.
The Pioneer ACOs did not, though, result in significant changes in hospital readmission rates, screening mammography, or hospitalizations for conditions like congestive heart failure, which research has shown can be prevented with appropriate ambulatory care. If you are going to argue for ACOs, it appears it will have to be on economic grounds, not big gains in health care quality. The Pioneers were associated with a small increase in the rate of use of preventive services for diabetes, according to the Harvard researchers.