A new study of an accountable care program for privately insured patients in Massachusetts found that the cost-sharing program led to lower costs for Medicare patients who were seen by the same providers (Source: “ACOs’ Coordinated Care Savings May Be Contagious,” Kaiser Health News, Aug. 28, 2013).
An accountable care organization, or ACO, is a network of doctors and hospitals that shares responsibility for providing care to a specific group of patients. The concept centers on paying providers for the quality of the services they provide, rather than the volume. The ACO is offered a bonus for giving patients high quality care at a reduced cost. But if they fail to hit certain quality targets or do not manage to reduce the cost of care, they will be paid less.
According to the study by researchers at the Harvard Medical School, within two years, providers in the private ACO-like Blue Cross Blue Shield Alternative Quality Contract, achieved significant savings for the Medicare patients they saw, relative to a control group of Medicare patients seen by providers at other Massachusetts hospitals. The average savings in outpatient care was $73 per patient, and “included significant differential changes in spending on office visits, emergency department visits, minor procedures, imaging, and laboratory tests.”
“The spillover savings in Medicare that we found suggest that at least some of the interventions providers adopted in response to the AQC [the private BCBS Alternative Quality Contract] changed the way care was delivered for all patients,” assistant professor J. Michael McWilliams, said in a press release.