Evidence map›Paper›PMID 31158012›Full record

ArticleHealth affairs (Project Hope)2019

ACO Serious Illness Care: Survey And Case Studies Depict Current Challenges And Future Opportunities.

William K Bleser, Robert S Saunders, Lia Winfield, Mark Japinga, Nathan Smith, Brystana G Kaufman, Hannah L Crook, David B Muhlestein, Mark McClellan

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Article in Health affairs (Project Hope), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

William K BleserWilliam K. Bleser is a research associate at the Duke-Margolis Center for Health Policy, Duke University, in Washington, D.C.
Robert S SaundersRobert S. Saunders ( robert.saunders@duke.edu ) is a research director at the Duke-Margolis Center for Health Policy, Duke University, in Washington, D.C.
Lia WinfieldLia Winfield is a manager at Leavitt Partners, in Salt Lake City, Utah.
Mark JapingaMark Japinga is a senior research assistant in the Duke-Margolis Center for Health Policy, Duke University, in Washington, D.C.
Nathan SmithNathan Smith is a research manager at Leavitt Partners, in Salt Lake City.
Brystana G KaufmanBrystana G. Kaufman is a postdoctoral research associate in the Duke-Margolis Center for Health Policy, Duke University, in Durham, North Carolina.
Hannah L CrookHannah L. Crook is a research assistant at the Duke-Margolis Center for Health Policy, Duke University, in Durham. She was a student of health policy and management at the University of North Carolina at Chapel Hill when this work was conducted.
David B MuhlesteinDavid B. Muhlestein is chief research officer at Leavitt Partners, in Washington, and an adjunct assistant professor at the Dartmouth Institute, Geisel School of Medicine, in Hanover, New Hampshire.
Mark McClellanMark McClellan is director of the Duke-Margolis Center for Health Policy, Duke University, in Washington, D.C., and the Robert J. Margolis Professor of Business, Medicine, and Policy at Duke University in Durham, North Carolina.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Care for people living with serious illness is suboptimal for many reasons, including underpayment for key services (such as care coordination and social supports) in fee-for-service reimbursement. Accountable care organizations (ACOs) have potential to improve serious illness care because of their widespread dissemination, strong financial incentives for care coordination in downside-risk models, and flexibility in shared savings spending. Through a national survey we found that 94 percent of ACOs at least partially identify their seriously ill beneficiaries, yet only 8-21 percent have widely implemented serious illness initiatives such as advance care planning or home-based palliative care. We selected six diverse ACOs with successful programs for case studies and interviewed fifty-three leaders and front-line personnel. Cross-cutting themes include the need for up-front investment beyond shared savings to build serious illness infrastructure and workforce; supporting the business case for organizational buy-in; how ACO contract specifications affect savings for serious illness populations; and using data and health information technology to manage populations. We discuss the implications of the recent Medicare ACO regulatory overhaul and other policies related to serious illness quality measures, risk adjustment, attribution methods, supporting rural ACOs, and enhancing timely data access.

Indexed as

Accountable Care OrganizationsChronic DiseaseOrganizational Case StudiesPalliative CareCost SavingsFee-for-Service PlansHealth ExpendituresHumansInterviews as TopicMedicareOrganizational InnovationSurveys and QuestionnairesUnited StatesAccountable Care OrganizationsHospice Carepalliative carepayment reformSerious Illness

Identifiers

PMID31158012

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.