Analysis: How Receiving Care Under Both ACOs and bundled Payments Affects Outcomes
In collaboration with colleagues on the Payment Insights Team and at the Leonard Davis Institute at the University of Pennsylvania, Dr. Joshua Liao recently published an analysis attempting to answer the following question:
Is receiving care simultaneously under a Medicare accountable care organization (ACO) and bundled payments associated with better patient outcomes compared with bundled payments alone? In a cohort study of 9 850 080 Medicare beneficiaries, Dr. Liao and colleagues use a quasi-experimental difference-in-differences method to compare episode outcomes for patients admitted to hospitals participating versus non-participating in a large nationwide Medicare bundled payment program, stratifying outcomes for patients patients who were and were not also attributed to a Medicare ACO.
They found that compared to inclusion in bundled payments alone, simultaneous inclusion in both ACOs and bundled payments was associated with:
differentially lower spending on institutional postacute care & fewer readmissions for medical episodes
differentially fewer readmissions for surgical episodes
The team's conclusion about their findings: they "suggest that receiving care under models such as ACOs may improve patient outcomes under bundled payments."