Five years after the implementation of the Accountable Care Act, it is still difficult to see how effective healthcare reform has been in reducing unnecessary clinical services.
However, a study published Monday in JAMA Internal Medicine is able to provide a better picture. It shows the Medicare Pioneer accountable care organization program was associated with modest reductions in "low-value" services in 2012, the first year of the program.
Authors of the study Aaron Schwartz, PhD, Michael Chernew, PhD, Bruce Landon, MD, and J. Michael McWilliams, MD, PhD, looked at 31 services considered to provide minimal clinical benefit to patients. They counted the annual number of these services provided per 100 beneficiaries and the annual spending per 100 beneficiaries across two groups: Medicare fee-for-service beneficiaries attributed to a Pioneer ACO and beneficiaries attributed to other healthcare providers.
They examined data for both groups from 2009 to 2011, before the advent of the program, and in 2012, the first year of the program.
Their results showed Pioneer ACOs reduced the quantity of low-value services by 1.9 percent in the first year, which was associated with a 4.5 percent reduction in spending on low-value services. ACOs that already provided more low-value services than the average organization in their market improved more than those who were already performing better than the market average, according to the study.
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