Accountable Care Organization Implementation Experiences and Rural Participation

Bagwell, Matt T.; Bushy, Angeline; Ortiz, Judith

doi:10.1097/nna.0000000000000433

Cited by 9 publications

(10 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…One study identified no relationship between EHR functionality and care management activities [40], but another found that using Certified EHRs and participating in either an ACO or patient-centered medical home (PCMH) was associated with the highest odds of performing population management, care coordination, quality measurement, and communication compared to physicians using a Certified EHR but not participating in an ACO or PCMH [8]. Six qualitative ACO-level studies found that ACO leaders emphasized the importance of health IT capabilities in achieving their quality, population health, or financial goals [162125354142]. Additionally, one study found that ACOs performing highly on quality and financial metrics reported extensive and sophisticated use of EHRs in their organizations as a factor for success [43].…”

Section: Resultsmentioning

confidence: 99%

Health Information Technology and Accountable Care Organizations: A Systematic Review and Future Directions

Balio

Apathy

Danek

2019

eGEMs

View full text Add to dashboard Cite

Background: Since the inception of Accountable Care Organizations (ACOs), many have acknowledged the potential synergy between ACOs and health information technology (IT) in meeting quality and cost goals. Objective: We conducted a systematic review of the literature in order to describe what research has been conducted at the intersection of health IT and ACOs and identify directions for future research. Methods: We identified empirical studies discussing the use of health IT via PubMed search with subsequent snowball reference review. The type of health IT, how health IT was included in the study, use of theory, population, and findings were extracted from each study. Results: Our search resulted in 32 studies describing the intersection of health IT and ACOs, mainly in the form of electronic health records and health information exchange. Studies were divided into three streams by purpose; those that considered health IT as a factor for ACO participation, health IT use by current ACOs, and ACO performance as a function of health IT capabilities. Although most studies found a positive association between health IT and ACO participation, studies that address the performance of ACOs in terms of their health IT capabilities show more mixed results. Conclusions: In order to better understand this emerging relationship between health IT and ACO performance, we propose future research should consider more quasi-experimental studies, the use of theory, and merging health, quality, cost, and health IT use data across ACO member organizations.

show abstract

Section: Resultsmentioning

confidence: 99%

Health Information Technology and Accountable Care Organizations: A Systematic Review and Future Directions

Balio

Apathy

Danek

2019

eGEMs

View full text Add to dashboard Cite

show abstract

“…In addition, because the Centers for Disease Control and Prevention (CDC) does not fund COPD programs, state and local public health departments have no local CDC‐generated data to use. An alternative source for gathering COPD data in rural communities is through accountable care organizations (ACOs) . Because COPD‐related health care costs due to disease flare‐ups are very high (e.g., they require more ED visits, hospital admissions, and readmissions), ACOs are demonstrating that it is cost effective to monitor and manage COPD to prevent or minimize acute episodes.…”

Section: Goal 3: Collect Analyze Report and Disseminate Copd‐relatmentioning

confidence: 99%

“…An alternative source for gathering COPD data in rural communities is through accountable care organizations (ACOs). 20,21 Because COPD-related health care costs due to disease flare-ups are very high (e.g., they require more ED visits, hospital admissions, and readmissions), ACOs are demonstrating that it is cost effective to monitor and manage COPD to prevent or minimize acute episodes. The ACO data that are used to monitor COPD care and patients' outcomes could be aggregated to support collaborative efforts in rural communities.…”

Section: Goal 3: Collect Analyze Report and Disseminate Copd-relatmentioning

confidence: 99%

COPD and Rural Health: A Dialogue on the National Action Plan

Moore

Atkins

Cramb

et al. 2019

The Journal of Rural Health

View full text Add to dashboard Cite

“…However, even as ACOs target their expansion efforts toward rural areas, 14 there is a limited understanding of how rural hospitals are affected by ACOs’ efforts to lower costs and reduce use of acute care services. Given the current precariousness of rural hospital financing, it is important to understand how ACOs affect rural hospitals.…”

mentioning

confidence: 99%

Assessing the Short‐Term Association Between Rural Hospitals’ Participation in Accountable Care Organizations and Changes in Utilization and Financial Performance

Comfort

Fulton

Shortell

2020

The Journal of Rural Health

View full text Add to dashboard Cite

Purpose Although much research has been done on accountable care organizations (ACOs), little is known about their impact on rural hospitals. We examine the association between rural hospitals’ participation in an ACO and their performance on utilization and financial measures. Methods This quasi‐experimental study estimates the relationship between voluntary ACO participation and hospital metrics using propensity score‐matched, longitudinal regression models with year and hospital fixed effects. Regression models controlled for secular trends and time‐varying hospital and county characteristics. Hospital measures were from the American Hospital Association, RAND Hospital Data, and Leavitt Partners. The initial population comprises 643 rural hospitals that participated in an ACO for at least one year during the 2011 to 2018 study period and 1,541 rural hospitals that did not participate in an ACO. From this population we created a sample of propensity score‐matched hospitals consisting of 525 ACO‐participating and 525 comparable non‐ACO hospitals. Results Rural hospitals’ participation in an ACO is not associated with changes in hospital utilization or financial measures, nor is there an association between these performance metrics and whether another within‐county hospital participated in an ACO. A secondary analysis limited to Critical Access Hospitals provides some evidence that inpatient utilization increases in the second year of ACO participation, though the increases are not significant in year 3 and beyond. Conclusion We find no evidence that rural hospitals experience substantive changes in outpatient visits, inpatient utilization, or operating margin in the years immediately after joining an ACO.

show abstract

Accountable Care Organization Implementation Experiences and Rural Participation

Cited by 9 publications

References 2 publications

Health Information Technology and Accountable Care Organizations: A Systematic Review and Future Directions

Health Information Technology and Accountable Care Organizations: A Systematic Review and Future Directions

COPD and Rural Health: A Dialogue on the National Action Plan

Assessing the Short‐Term Association Between Rural Hospitals’ Participation in Accountable Care Organizations and Changes in Utilization and Financial Performance

Contact Info

Product

Resources

About