Utilization by Long-Term Nursing Home Residents Under Accountable Care Organizations.

Journal of the American Medical Directors Association
Chiang-Hua ChangJulie P W Bynum

Abstract

Nursing home care is common and costly. Accountable care organization (ACO) payment models, which have incentives for care that is better coordinated and less reliant on acute settings, have the potential to improve care for this high-cost population. We examined the association between ACO attribution status and utilization and Medicare spending among long-term nursing home residents and hypothesized that attribution of nursing home residents to an ACO will be associated with lower total spending and acute care use. Observational propensity-matched study. Medicare fee-for-service beneficiaries who were long-term nursing home residents residing in areas with ≥5% ACO penetration. ACO attribution and covariates used in propensity matching were measured in 2013 and outcomes were measured in 2014, including hospitalization (total and ambulatory care sensitive conditions), outpatient emergency department visits, and Medicare spending. Nearly one-quarter (23.3%) of nursing home residents who survived into 2014 (n = 522,085, 76.1% of 2013 residents) were attributed to an ACO in 2013 in areas with ≥5% ACO penetration. After propensity score matching, ACO-attributed residents had significantly (P < .001) lower hospitalization rates per ...Continue Reading

References

Mar 24, 2004·Medical Care Research and Review : MCRR·David C Grabowski, Nicholas G Castle
Oct 6, 2005·The Milbank Quarterly·Vincent Mor
Dec 12, 2007·The Milbank Quarterly·David C Grabowski
Jul 30, 2008·Journal of the American Geriatrics Society·Carrie HovermanMelinda Beeuwkes Buntin
Jan 6, 2010·Health Affairs·Terence NgMartin Kitchener
Oct 14, 2011·The New England Journal of Medicine·Pedro GozaloVincent Mor
Nov 19, 2011·Journal of the American Geriatrics Society·Henry E WangMeredith Kilgore
Apr 13, 2012·American Journal of Alzheimer's Disease and Other Dementias·Judith BentkoverVincent Mor
Aug 7, 2014·JAMA : the Journal of the American Medical Association·Jing Cao, Song Zhang
Apr 16, 2015·The New England Journal of Medicine·J Michael McWilliamsAaron L Schwartz
May 6, 2015·JAMA : the Journal of the American Medical Association·David J NyweidePatrick H Conway
Jul 1, 2015·Journal of Health Politics, Policy and Law·Stephen M ShortellPatricia Ramsay
Jun 15, 2016·Journal of the American Medical Directors Association·Mia YangJulie P W Bynum
Oct 27, 2016·JAMA : the Journal of the American Medical Association·J Michael McWilliams
Feb 14, 2017·JAMA Internal Medicine·J Michael McWilliamsDavid C Grabowski
Dec 31, 2017·Journal of the American Medical Directors Association·Andrew R ZulloSarah D Berry
Jun 16, 2018·Circulation. Cardiovascular Quality and Outcomes·John M HollingsworthAndrew M Ryan
Jul 4, 2018·Medical Care Research and Review : MCRR·Gregory KennedyCarrie H Colla
Oct 26, 2018·Circulation. Cardiovascular Quality and Outcomes·Shashank S SinhaJohn M Hollingsworth
Oct 1, 2019·Medical Care·Chiang-Hua ChangJulie Bynum

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Journal of the American Medical Directors Association
William R Mills, Steven H Landers
Medical Economics
Morgan Lewis
The Journal of Medical Practice Management : MPM
Neville M Bilimoria
© 2021 Meta ULC. All rights reserved