ArticleHealth services research2021
Impact of the Medicare Shared Savings Program on utilization of mental health and substance use services by eligibility and race/ethnicity.
Article in Health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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.
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
8 citing papers in PubMed, 19 citations in OpenAlex.
- Characteristics of accountable care organizations offering methadone to patients with opioid use disorder.Health affairs scholar · 2025Article
- A roadmap for sustainable implementation of vocational rehabilitation for people with mental disorders and its outcomes: a qualitative evaluation.International journal of mental health systems · 2024Article
- No Improvement In Mental Health Treatment Or Patient-Reported Outcomes At Medicare ACOs For Depression And Anxiety Disorders.Health affairs (Project Hope) · 2023Article
- The impact of Medicare shared savings program participation on hospital financial performance: An event-study analysis.Health services research · 2023Article
- Innovations in Care Delivery for Patients With Serious Mental Illness Among Accountable Care Organizations.Psychiatric services (Washington, D.C.) · 2022Article
- Impact of the Medicare Shared Savings Program on utilization of mental health and substance use services by eligibility and race/ethnicity.Health services research · 2021Article
- Taking account of accountable care.Health services research · 2021Article
- The Effect of Network-Level Payment Models on Care Network Performance: A Scoping Review of the Empirical Literature.International journal of integrated careArticle
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo assess the impact of the Medicare Shared Savings Program (MSSP) ACOs on mental health and substance use services utilization and racial/ethnic disparities in care for these conditions. DATA SOURCES: Five percent random sample of Medicare claims from 2009 to 2016. STUDY
designWe compared Medicare beneficiaries in MSSP ACOs to non-MSSP beneficiaries, stratifying analyses by Medicare eligibility (disability vs age 65+). We estimated difference-in-difference models of MSSP ACOs on mental health and substance use visits (outpatient and inpatient), medication fills, and adequate care for depression adjusting for age, sex, race/ethnicity, region, and chronic medical and behavioral health conditions. To examine the differential impact of MSSP on our outcomes by race/ethnicity, we used a difference-in-difference-in-differences (DDD) design. DATA COLLECTION/EXTRACTION
methodsNot applicable. PRINCIPAL
findingsMSSP ACOs were associated with small reductions in outpatient mental health (Coeff: -0.012, P < .001) and substance use (Coeff: -0.001, P < .01) visits in the disability population, and in adequate care for depression for both the disability- and age-eligible populations (Coeff: -0.028, P < .001; Coeff: -0.012, P < .001, respectively). MSSP ACO's were also associated with increases in psychotropic medications (Coeff: 0.007 and Coeff: 0.0213, for disability- and age-eligible populations, respectively, both P < .001) and reductions in inpatient mental health stays (Coeff:-0.004, P < .001, and Coeff:-0.0002, P < .01 for disability- and age-eligible populations, respectively) and substance use-related stays for disability-eligible populations (Coeff:-0.0005, P<.05). The MSSP effect on disparities varied depending on type of service.
conclusionsWe found small reductions in outpatient and inpatient stays and in rates of adequate care for depression associated with MSSP ACOs. As MSSP ACOs are placed at more financial risk for population-based treatment, it will be important to include more robust behavioral health quality measures in their contracts and to monitor disparities in care.
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Registered trials
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