Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel

Preventive Care Quality of Medicare Accountable Care Organizations: Associations of Organizational Characteristics With Performance.

Publication ,  Journal Article
Albright, BB; Lewis, VA; Ross, JS; Colla, CH
Published in: Med Care
March 2016

BACKGROUND: Accountable Care Organizations (ACOs) are a delivery and payment model aiming to coordinate care, control costs, and improve quality. Medicare ACOs are responsible for 8 measures of preventive care quality. OBJECTIVES: To create composite measures of preventive care quality and examine associations of ACO characteristics with performance. DESIGN: This is a cross-sectional study of Medicare Shared Savings Program and Pioneer participants. We linked quality performance to descriptive data from the National Survey of ACOs. We created composite measures using exploratory factor analysis, and used regression to assess associations with organizational characteristics. RESULTS: Of 252 eligible ACOs, 246 reported on preventive care quality, 177 of which completed the survey (response rate=72%). In their first year, ACOs lagged behind PPO performance on the majority of comparable measures. We identified 2 underlying factors among 8 measures and created composites for each: disease prevention, driven by vaccines and cancer screenings, and wellness screening, driven by annual health screenings. Participation in the Advanced Payment Model, having fewer specialists, and having more Medicare ACO beneficiaries per primary care provider were associated with significantly better performance on both composites. Better performance on disease prevention was also associated with inclusion of a hospital, greater electronic health record capabilities, a larger primary care workforce, and fewer minority beneficiaries. CONCLUSIONS: ACO preventive care quality performance is related to provider composition and benefitted by upfront investment. Vaccine and cancer screening quality performance is more dependent on organizational structure and characteristics than performance on annual wellness screenings, likely due to greater complexity in eligibility determination and service administration.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Med Care

DOI

EISSN

1537-1948

Publication Date

March 2016

Volume

54

Issue

3

Start / End Page

326 / 335

Location

United States

Related Subject Headings

  • United States
  • Quality of Health Care
  • Quality Indicators, Health Care
  • Preventive Health Services
  • Medicare
  • Male
  • Humans
  • Health Policy & Services
  • Health Expenditures
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Albright, B. B., Lewis, V. A., Ross, J. S., & Colla, C. H. (2016). Preventive Care Quality of Medicare Accountable Care Organizations: Associations of Organizational Characteristics With Performance. Med Care, 54(3), 326–335. https://doi.org/10.1097/MLR.0000000000000477
Albright, Benjamin B., Valerie A. Lewis, Joseph S. Ross, and Carrie H. Colla. “Preventive Care Quality of Medicare Accountable Care Organizations: Associations of Organizational Characteristics With Performance.Med Care 54, no. 3 (March 2016): 326–35. https://doi.org/10.1097/MLR.0000000000000477.
Albright, Benjamin B., et al. “Preventive Care Quality of Medicare Accountable Care Organizations: Associations of Organizational Characteristics With Performance.Med Care, vol. 54, no. 3, Mar. 2016, pp. 326–35. Pubmed, doi:10.1097/MLR.0000000000000477.

Published In

Med Care

DOI

EISSN

1537-1948

Publication Date

March 2016

Volume

54

Issue

3

Start / End Page

326 / 335

Location

United States

Related Subject Headings

  • United States
  • Quality of Health Care
  • Quality Indicators, Health Care
  • Preventive Health Services
  • Medicare
  • Male
  • Humans
  • Health Policy & Services
  • Health Expenditures
  • Female