Evidence map›Paper›PMID 32715464›Full record

ArticleHealth services research2020

Association between specialist compensation and Accountable Care Organization performance.

Ishani Ganguli, Claire Lupo, Alexander J Mainor, Endel John Orav, Bonnie B Blanchfield, Valerie A Lewis, Carrie H Colla

Abstract read
In one paragraph

Article in Health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Ishani GanguliDivision of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts.ORCID 0000-0002-3793-0995
Claire LupoDivision of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts.
Alexander J MainorGeisel School of Medicine at Dartmouth, The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire.ORCID 0000-0001-9854-9365
Endel John OravDivision of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts.
Bonnie B BlanchfieldDivision of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts.
Valerie A LewisDepartment of Health Policy and Management, Gillings School of Global Public Health, Chapel Hill, North Carolina.ORCID 0000-0003-1896-1240
Carrie H CollaGeisel School of Medicine at Dartmouth, The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire.ORCID 0000-0002-8414-5084

Funding

Translational Engineering in Cancer (TEC)P30CA023108 · NCI · DARTMOUTH COLLEGE · PI Fred W Kolling IV · 1985 to 2026
$91.3M
SYNERGY: The Dartmouth Center for clinical and Translational ScienceUL1TR001086 · NCATS · DARTMOUTH COLLEGE · PI GREEN, ALAN I · 2013 to 2017
$18.3M
Learning from Medicare Payment Reform: Economic Effects of ACO IncentivesR33AG044251 · NIA · DARTMOUTH COLLEGE · PI COLLA, CARRIE HOVERMAN · 2014 to 2016
$1.5M
The Effects of Accountable Care Organizations on Health Care DisparitiesK01AG049914 · NIA · UNIV OF NORTH CAROLINA CHAPEL HILL · PI LEWIS, VALERIE A · 2015 to 2019
$646k
Agency for Healthcare Research and Quality 1R01HS023812AHRQ HHS R01 HS023812NCATS NIH HHS UL1 TR001086NCI NIH HHS P30 CA023108NIA NIH HHS K01 AG049914NIA NIH HHS R33 AG044251NIA NIH HHS R33AG044251
6 · The paper itself

Abstract

objectiveTo determine if Medicare Shared Savings Program Accountable Care Organizations (ACOs) using cost reduction measures in specialist compensation demonstrated better performance. DATA SOURCES: National, cross-sectional survey data on ACOs (2013-2015) linked to public-use data on ACO performance (2014-2016). STUDY

designWe compared characteristics of ACOs that did and did not report use of cost reduction measures in specialist compensation and determined the association between using this approach and ACO savings, outpatient spending, and specialist visit rates. PRINCIPAL

findingsOf 160 ACOs surveyed, 26 percent reported using cost reduction measures to help determine specialist compensation. ACOs using cost reduction in specialist compensation were more often physician-led (68.3 vs 49.6 percent) and served higher-risk patients (mean Hierarchical Condition Category score 1.09 vs 1.05). These ACOs had similar savings per beneficiary year (adjusted difference $82.6 [95% CI -77.9, 243.1]), outpatient spending per beneficiary year (-24.0 [95% CI -248.9, 200.8]), and specialist visits per 1000 beneficiary years (369.7 [95% CI -9.3, 748.7]).

conclusionIncentivizing specialists on cost reduction was not associated with ACO savings in the short term. Further work is needed to determine the most effective approach to engage specialists in ACO efforts.

Indexed as

Accountable Care OrganizationsAdultAgedCost ControlCross-Sectional StudiesFemaleHealth ExpendituresHumansMaleMedicareMiddle AgedPhysician Incentive PlansSpecializationUnited StatesAccountable Care Organizationscost reductionspecialistsvalue-based payment

Identifiers

PMID32715464
PMCPMC7518824

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Registered trials

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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.