Changes in specialty care use and leakage in Medicare accountable care organizations.

ABSTRACT:

Objectives

Reducing leakage to outside specialists has been promoted as a key strategy for accountable care organizations (ACOs). We sought to examine changes in specialty care leakage and use associated with the Medicare Shared Savings Program (MSSP).

Study design

Analyses of trends in ACOs from 2010 to 2014 and quasi-experimental difference-in-differences analyses comparing changes for ACOs versus local non-ACO providers from before until after the start of ACO contracts, stratified by ACO specialty composition and year of MSSP entry.

Methods

We used Medicare claims for a 20% sample of beneficiaries attributed to ACOs or non-ACO providers. The main beneficiary-level outcome was the annual count of new specialist visits. ACO-level outcomes included the proportion of

SUBMITTER: Barnett ML 

PROVIDER: S-EPMC5986093 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature