Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, Iowa.
J Rural Health. 2019 Jan;35(1):68-77. doi: 10.1111/jrh.12304. Epub 2018 May 8.
To evaluate associations between geographic, structural, and service-provision attributes of Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) and the ACOs' quality performance.
We conducted cross-sectional and longitudinal analyses of ACO quality performance using data from the Centers for Medicare and Medicaid Services and additional sources. The sample included 322 and 385 MSSP ACOs that had successfully reported quality measures in 2014 and 2015, respectively.
Results show that after adjusting for other organizational factors, rural ACOs' average quality score was comparable to that of ACOs serving other geographic categories. ACOs with hospital-system sponsorship, larger beneficiary panels, and higher posthospitalization follow-up rates achieved better quality performance.
There is no significant difference in average quality performance between rural ACOs and other ACOs after adjusting for structural and service-provision factors. MSSP ACO quality performance is positively associated with hospital-system sponsorship, beneficiary panel size, and posthospitalization follow-up rate.
评估参与医疗保险储蓄计划（MSSP）的问责制医疗组织（ACO）的地理、结构和服务提供属性与其质量绩效之间的关联。
我们使用医疗保险和医疗补助服务中心及其他来源的数据，对 ACO 的质量绩效进行了横断面和纵向分析。样本包括分别于 2014 年和 2015 年成功报告质量措施的 322 家和 385 家 MSSP ACO。
结果表明，在调整其他组织因素后，农村 ACO 的平均质量评分与服务于其他地理类别的 ACO 相当。具有医院系统赞助、更大的受益人群和更高的住院后随访率的 ACO 实现了更好的质量绩效。
在调整结构和服务提供因素后，农村 ACO 的平均质量绩效与其他 ACO 之间没有显著差异。MSSP ACO 的质量绩效与医院系统赞助、受益人群规模和住院后随访率呈正相关。
