Evidence map›Paper›PMID 33861869›Full record

ArticleHealth services research2021

The one-year impact of accountable care networks among Washington State employees.

Norma B Coe, Bailey Ingraham, Elaine Albertson, Lingmei Zhou, Suzanne Wood, David Grembowski, Douglas Conrad

Open access · greenAbstract read
In one paragraph

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 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.5field-weighted citation impact, top 12% of its field
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

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. Taking account of accountable care.Health services research · 2021
    Article
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 at 2 institutions in 2 countries.

Norma B CoeDepartment of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0000-0003-1228-0938
Bailey IngrahamDepartment of Health Services, School of Public Health, University of Washington, Seattle, Washington, USA.
Elaine AlbertsonUCLA Fielding School of Public Health, Los Angeles, California, USA.
Lingmei ZhouDepartment of Medicine, University of Washington School of Medicine, Seattle, Washington, USA.
Suzanne WoodDepartment of Health Services, School of Public Health, University of Washington, Seattle, Washington, USA.ORCID 0000-0003-3017-2738
David GrembowskiDepartment of Health Services, School of Public Health, University of Washington, Seattle, Washington, USA.
Douglas ConradDepartment of Health Services, School of Public Health, University of Washington, Seattle, Washington, USA.
University of Washington · USUniversity of Pennsylvania · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo estimate the impact of a new, two-sided risk model accountable care network (ACN) on Washington State employees and their families. DATA SOURCES/STUDY

settingAdministrative data (January 2013-December 2016) on Washington State employees. STUDY

designWe compared monthly health care utilization, health care intensity as measured through proxy pricing, and annual HEDIS quality metrics between the five intervention counties to 13 comparison counties, analyzed separately by age categories (ages 0-5, 6-18, 19-26, 18-64). DATA COLLECTION/EXTRACTION

methodsWe used difference-in-difference methods and generalized estimating equations to estimate the effects after 1 year of implementation for adults and children. PRINCIPAL

findingsWe estimate a 1-2 percentage point decrease in outpatient hospital visits due to the introduction of ACNs (adults: -1.8, P < .01; age 0-5: -1.2, P = .07; age 6-18: -1.2, P = .06; age 19-26; -1.2, P < .01). We find changes in primary and specialty care office visits; the direction of impact varies by age. Dependents age 19-26 were also responsive with inpatient admissions declines (-0.08 percentage points, P = .02). Despite changes in utilization, there was no evidence of changes in intensity of care and mixed results in the quality measures.

conclusionsWashington's state employee ACN introduction changed health care utilization patterns in the first year but was not as successful in improving quality.

Indexed as

Accountable Care OrganizationsAdolescentAdultAge FactorsChildChild, PreschoolFemaleHealth ServicesHospitalizationHumansInfantInfant, NewbornInsurance Claim ReviewLongitudinal StudiesMaleMiddle Agedaccountable care networkhealth insurancequalityutilizationvalue-based contractWashington

Identifiers

PMID33861869
PMCPMC8313948
OpenAlexW3154350516

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.