ACO patients older, wealthier than counterparts

Compared to patients not part of an accountable care organization (ACO), ACO patients tend to be older than 80 years old and earn higher incomes, and are less likely to be black, covered by Medicaid or disabled. Meanwhile, the cost of care for ACO patients was slightly lower than for non-ACO patients, according to a study published in Health Affairs.

Conducted by researchers within the Harvard School of Public Health, the study examined baseline characteristics of early entrants in ACOs and compared costs and quality of ACOs with their non-ACO counterparts at baseline. They obtained publicly available lists from the Centers for Medicare & Medicaid Services of the 254 ACOs that had joined either Pioneer or Sharing Savings Program ACOs through January 2013.

The study revealed that ACOs were more heavily concentrated in southern part of the U.S., and that regional distribution did not change substantially between 2012 and 2013. Fewer than half of ACOs had a participating hospital, and hospitals within ACOs were more likely than others to be large, teaching and not-for-profit. There was little difference in their performance on quality metrics, the researchers found.

“Although modest, the differences in socioeconomic characteristics between patients in ACOs and other patients raise concerns about ensuring that people of lower socioeconomic status have equal access with those of higher socioeconomic status to any benefits that ACOs may provide. Further studies should address how these patterns evolve,” wrote lead author Arnold M. Epstein, professor of health policy and management, Harvard School of Public Health and colleagues.

The study is available here (requires log-in).