Effect of Hospital and Post‐Acute Care Provider Participation in Accountable Care Organizations on Patient Outcomes and Medicare Spending

Objective

To test for differences in patient outcomes when hospital and post‐acute care () providers participate in accountable care organizations (s).

Data/Setting

Using Medicare claims, we examined changes in readmission, Medicare spending, and length of stay among patients admitted to ‐participating hospitals and providers.

Design

We compared changes in outcomes among patients discharged from ‐participating hospitals/s before and after participation to changes among patients discharged from non‐participating hospitals/s over the same time period.

Results

Patients discharged from an ‐participating hospitals and skilled nursing facilities () had lower readmission rates (−1.7 percentage points, ‐value = .03) than before participation and non‐participants; and lower per‐discharge Medicare spending (−$940, ‐value = .001), and length of stay (−3.1 days, ‐value <.001) in . Effects among ‐participating hospitals without a co‐participating were smaller. Patients discharged from an ‐participating hospital and home health agency had lower Medicare per‐discharge spending (−$209; ‐value = .06) and length of stay (−1.6 days, ‐value <.001) for home health compared to before participation and non‐participants. Discharge from an ‐participating hospital and inpatient rehabilitation facility did not impact patient outcomes or spending.

Conclusions

Hospital and participation in an was associated with lower readmission rates, Medicare spending on , and length of stay. These results lend support to the payment model.