Evidence map›Paper›PMID 37126741›Full record

ArticleHealth affairs (Project Hope)2023

Benchmarking Changes And Selective Participation In The Medicare Shared Savings Program.

Peter F Lyu, Michael E Chernew, J Michael McWilliams

Abstract read
In one paragraph

Article in Health affairs (Project Hope), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing 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

6 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

3 authors.

Peter F LyuPeter F. Lyu (plyu@rti.org), RTI International, Research Triangle Park, North Carolina.
Michael E ChernewMichael E. Chernew, Harvard University, Boston, Massachusetts.
J Michael McWilliamsJ. Michael McWilliams, Harvard University and Brigham and Women's Hospital, Boston, Massachusetts.

Funding

Tradeoffs in the Design of Public Long-Term Care BenefitsP01AG032952 · NIA · HARVARD MEDICAL SCHOOL · PI Bruce E. Landon · 2009 to 2026
$39.0M
Strategic Behavior Among Provider Organizations in Risk-Sharing ContractsR36HS027531 · AHRQ · HARVARD MEDICAL SCHOOL · PI LYU, PETER · 2020 to 2020
$39k
AHRQ HHS R36 HS027531NIA NIH HHS P01 AG032952
6 · The paper itself

Abstract

In 2017 the Medicare Shared Savings Program (MSSP) began incorporating regional spending into accountable care organization (ACO) benchmarks, thus favoring the participation of ACOs and practices with lower baseline spending than their region. To characterize providers' responses to these incentives, we isolated changes in spending due to changes in the mix of ACOs and practices participating in the MSSP. In contrast to earlier participation patterns, the composition of the MSSP after 2017 increasingly shifted to providers with lower preexisting levels of spending relative to their region, consistent with a selection response. Changes occurred through the entry of new ACOs with lower baseline spending, the exit of higher-spending ACOs, and the reconfiguration of participant lists favoring lower-spending practices within continuing ACOs. These participation patterns varied meaningfully by ACO type. Although compositional changes could not be definitively tied to benchmarking changes, the disproportionate participation of providers with lower baseline spending implies substantial costs and the need for ACO benchmarking reforms.

Indexed as

Accountable Care OrganizationsBenchmarkingAgedCost SavingsHumansMedicareUnited States

Identifiers

PMID37126741
PMCPMC10228701

What OpenQuestion holds

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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.