ArticleAnnals of surgery2019
Association Between Hospital Participation in Medicare Shared Savings Program Accountable Care Organizations and Readmission Following Major Surgery.
Article in Annals of surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Value-Based Provider Payment Initiatives Combining Global Payments With Explicit Quality Incentives: A Systematic Review.Medical care research and review : MCRR · 2020Pooled it
- Value-based payment models and management of newly diagnosed prostate cancer.Cancer medicine · 2024Article
- Accountable care organizations and use of surgery among patients with Alzheimer disease and related dementias.The American journal of managed care · 2023Article
- The impact of Medicare shared savings program participation on hospital financial performance: An event-study analysis.Health services research · 2023Article
- Likelihood of hospital readmission in Medicare Advantage and Fee-For-Service within same hospital.Health services research · 2020Article
- Drug Enforcement Agency 2014 Hydrocodone Rescheduling Rule and Opioid Dispensing after Surgery.Anesthesiology · 2020Article
- Trends in the Cost of Cancer Care: Beyond Drugs.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2020Review
- Prostate cancer in the medicare shared savings program: are Accountable Care Organizations associated with reduced expenditures for men with prostate cancer?Prostate cancer and prostatic diseases · 2019Article
- Novel Machine Learning Approach to Identify Preoperative Risk Factors Associated With Super-Utilization of Medicare Expenditure Following Surgery.JAMA surgery · 2019Observational
- Medicare Accountable Care Organizations and Use of Potentially Low-Value Procedures.Surgical innovation · 2019Article
- What Can Canada Learn From Accountable Care Organizations: A Comparative Policy Analysis.International journal of integrated careArticle
- The Effect of Network-Level Payment Models on Care Network Performance: A Scoping Review of the Empirical Literature.International journal of integrated careArticle
- Nurse Practitioner Involvement in Medicare Accountable Care Organizations: Association With Quality of Care.American journal of medical quality : the official journal of the American College of Medical QualityArticle
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
objectiveTo evaluate the effect of Medicare Shared Savings Program accountable care organizations (ACOs) on hospital readmission after common surgical procedures. SUMMARY BACKGROUND DATA: Hospital readmissions following surgery lead to worse patient outcomes and wasteful spending. ACOs, and their associated hospitals, have strong incentives to reduce readmissions from 2 distinct Centers for Medicare and Medicaid Services policies.
methodsWe performed a retrospective cohort study using a 20% national Medicare sample to identify beneficiaries undergoing 1 of 7 common surgical procedures-abdominal aortic aneurysm repair, colectomy, cystectomy, prostatectomy, lung resection, total knee arthroplasty, and total hip arthroplasty-between 2010 and 2014. The primary outcome was 30-day risk-adjusted readmission rate. We performed difference-in-differences analyses using multilevel logistic regression models to quantify the effect of hospital ACO affiliation on readmissions following these procedures.
resultsPatients underwent a procedure at one of 2974 hospitals, of which 389 were ACO affiliated. The 30-day risk-adjusted readmission rate decreased from 8.4% (95% CI, 8.1-8.7%) to 7.0% (95% CI, 6.7-7.3%) for ACO affiliated hospitals (P < 0.001) and from 7.9% (95% CI, 7.8-8.0%) to 7.1% (95% CI, 6.9-7.2%) for non-ACO hospitals (P < 0.001). The difference-in-differences of the 2 trends demonstrated an additional 0.52% (95% CI, 0.97-0.078%) absolute reduction in readmissions at ACO hospitals (P = 0.021), which would translate to 4410 hospitalizations avoided.
conclusionReadmissions following common procedures decreased significantly from 2010 to 2014. Hospital affiliation with Shared Savings ACOs was associated with significant additional reductions in readmissions. This emphasis on readmission reduction is 1 mechanism through which ACOs improve value in a surgical population.
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