ArticleHealth affairs (Project Hope)2018
Changes In End-Of-Life Care In The Medicare Shared Savings Program.
Article in Health affairs (Project Hope), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed.
- Multi-Level Factors Impacting Implementation of Outpatient Palliative Care: Perceptions of VA Providers.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026Article
- Provider Perspectives on Implementation of Adult Community-Based Palliative Care: A Scoping Review.Medical care research and review : MCRR · 2025Article
- End-of-Life Care and Health Care Spending for Medicare Beneficiaries With Dementia in Accountable Care Organizations.JAMA health forum · 2025Article
- Do Medicare Accountable Care Organizations Impact Health Care Utilization among Long-Stay Nursing Home Residents?Journal of the American Medical Directors Association · 2025Article
- ACO Spending and Utilization Among Medicare Patients at the End of Life: an Observational Study.Journal of general internal medicine · 2022Observational
- Small practice participation and performance in Medicare accountable care organizations.The American journal of managed care · 2022Article
- Trends and racial disparities in aggressive end-of-life care for a national sample of women with ovarian cancer.Cancer · 2021Article
- Early Accountable Care Organization Results in End-of-Life Spending Among Cancer Patients.Journal of the National Cancer Institute · 2019Article
- Aggressive Care near the End of Life for Cancer Patients in Medicare Accountable Care Organizations.Journal of the American Geriatrics Society · 2019Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
End-of-life care is often overly aggressive and inconsistent with patients' preferences. Although end-of-life care could therefore be a natural target for accountable care organizations (ACOs) in their efforts to reduce spending, identifying and curbing wasteful care for patients at high risk of death may be challenging. To date, the impact of ACOs on end-of-life care has not been quantified. Using fee-for-service Medicare claims through 2015 and a difference-in-differences approach, we found evidence of some changes in end-of-life care associated with providers' participation in the Medicare Shared Savings Program among both decedents and patients at high risk of death. Although generally suggestive of less aggressive care, most effects were small and inconsistent across cohorts of ACOs entering the program in different years. This suggests that ACOs have not yet substantially altered end-of-life care patterns and that additional incentives, time, or both may be needed. Alternatively, curbing wasteful end-of-life care might not be a viable source of substantial savings under population-based payment models.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.