Older adults receive less preventive care when doctors leave Medicare ACOs
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Older patients are less likely to receive crucial preventive services when their provider group leaves an Accountable Care Organization, according to research published in JAMA Health Forum.
Over the past decade, doctors and their practices have been offered extra financial incentives for improving care quality and managing costs as part of an ACO. But many physician groups have dropped out of these arrangements as of late, and it’s beginning to affect patients.
In the first two years after physicians exited an ACO, Medicare beneficiaries underwent fewer screenings than those whose docs remained in an ACO. This included fewer preventive tests to measure high blood sugar or cholesterol levels, and eye exams to check for disease.
“While more than 11 million older Americans receive care from at least one of the 529,000 physicians or other providers who take part in any one of 483 ACOs, those numbers are down from peaks in 2020,” lead author Yajuan Si, PhD, with the University of Michigan Institute for Social Research, said in a news release. “Our findings highlight the need to monitor quality at exiting practices.”
The findings are based on a retrospective analysis of 1.7 million beneficiaries (average age 75.2 years old) who received care from an ACO-participating provider also taking part in the Medicare Shared Savings Program at some time between 2012 and 2016.
While patients did receive less preventive care two years after their provider left an ACO, such services showed signs of normalizing in the third year after a group stopped participating.
These trends may be tied, in part, to requiring participating ACOs to take on additional financial risks, the authors noted.
“The addition of ‘downside risk’ to the Shared Savings Program under a recent program overhaul, which means ACOs can lose money if they don’t achieve goals for improving quality of care or containing cost growth, and the cost of paying for systems and staff to drive improved care, may have contributed to the issue,” added John Hollingsworth, MD, MS, with the University of Michigan’s Division of Health Services Research.
Read the full study here.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.