Evaluations of three accountable care organization payment models revealed successes in overall performance and spending, but further assessment is required to address their effect on patients’ health and quality of life, according to two studies and an editorial published in JAMA Internal Medicine.
The ACO models included the Medicare Shared Savings Program, Colorado’s Accountable Care Collaborative, and Oregon’s Coordinated Care Organizations.
A comparison of Oregon’s and Colorado’s Medicaid ACO models revealed similar spending patterns; however, more improvements in some measures of utilization, access and quality were observed in Oregon’s model, according to McConnell and colleagues.
Using a difference-in-differences approach, the researchers compared the performance of Oregon’s and Colorado’s Medicaid ACO models, which were initiated in 2012 and 2011, respectively. They analyzed data from Jul. 1, 2010 to Dec. 31, 2014 — 18 months prior to and 24 months after intervention — of 452,371 Oregon and 330,511 Colorado Medicaid enrollees (45% male; mean age, 16.74 years) for changes in expenditure, utilization and quality outcomes. Oregon’s ACO was supported by a federal government investment of $1.9 billion and moved management of care of enrollees within a global budget, while Colorado’s ACO received funding to coordinate care and connect Medicaid enrollees with community services.