Hawken Scott R, Herrel Lindsey A, Ellimoottil Chandy, Ye Zaojun, Hollenbeck Brent K, Miller David C
Department of Urology, University of Michigan, Ann Arbor, MI.
Department of Urology, University of Michigan, Ann Arbor, MI.
Urology. 2016 Apr;90:76-80. doi: 10.1016/j.urology.2015.12.053. Epub 2016 Jan 22.
To understand the current role of urologists in Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs) and the organizational characteristics of ACOs with participating urologists.
Using 2012-2013 Medicare data and the National Provider Identifier Database, we classified each urologist in the U.S. and Puerto Rico as either an MSSP ACO participant or nonparticipating provider. We then examined the distribution of ACO-participating urologists across the U.S. and among the first 220 MSSP ACOs. We also compared the characteristics of ACOs with and without participating urologists.
Among 11,084 identified urologists, 1118 (10%) were MSSP ACO participants. ACO-participating urologists practiced more frequently in the Northeast and Midwest (P < .001), and were more commonly female (10% vs 8%, P = .003). At an organizational level, only 110 (50%) of the initial MSSP ACOs included at least one urologist; among this group, the number of participating urologists ranged from 1 to 55. ACOs with one or more participating urologist were larger organizations, with respect to both the number of assigned beneficiaries and the number of providers per 1000 beneficiaries (P < .001 for each comparison). The patient populations served by ACOs with and without urologists were similar (P > .05 for each comparison).
A modest percentage of urologists participate in MSSP ACOs, although many of these organizations still lack any formal involvement by urological surgeons. Without such participation, improving the coordination, quality, and cost of urologic care for Medicare beneficiaries may be more challenging.
了解泌尿科医生在医疗保险共同储蓄计划（MSSP） accountable care organizations（ACO）中的当前角色，以及有参与的泌尿科医生的ACO的组织特征。
利用2012 - 2013年医疗保险数据和国家提供者识别数据库，我们将美国和波多黎各的每位泌尿科医生分类为MSSP ACO参与者或非参与提供者。然后我们研究了参与ACO的泌尿科医生在美国以及前220个MSSP ACO中的分布情况。我们还比较了有和没有参与的泌尿科医生的ACO的特征。
在11084名已识别的泌尿科医生中，1118名（10%）是MSSP ACO参与者。参与ACO的泌尿科医生在东北部和中西部的执业频率更高（P <.001），并且女性更为常见（10%对8%，P =.003）。在组织层面，最初的MSSP ACO中只有110个（50%）至少包括一名泌尿科医生；在这一组中，参与的泌尿科医生数量从1到55不等。就分配的受益人数和每1000名受益人中的提供者数量而言，有一名或多名参与的泌尿科医生的ACO是更大的组织（每次比较P <.001）。有和没有泌尿科医生参与的ACO所服务的患者群体相似（每次比较P >.05）。
尽管许多这些组织仍然缺乏泌尿外科医生的任何正式参与，但仍有适度比例的泌尿科医生参与MSSP ACO。没有这种参与，改善医疗保险受益人的泌尿科护理的协调、质量和成本可能更具挑战性。
