ACO Success Rates on Quality Measures Vary

CMS recently released data on five of the 33 quality measures tracked by 141 accountable care organizations in 2012, revealing that ACOs had varying success controlling patients' diabetes and heart disease.

Kaiser Health News performed an analysis of the newly released data, which shows, for example, that ACOs succeeded at keeping diabetes patients' blood pressure below Medicare's target for 67 percent of patients on average.

Eighty-eight percent of Minneapolis-based Allina Health's diabetes patients, however, had their blood pressure under 140/90 mmHg. On the other hand, just 9 percent of patients in John Muir Health's Medicare ACO in Walnut Creek, Calif., held their blood pressure in check, according to CMS data.

John Muir Health says the low success rate on the diabetic blood pressure metric is due to "reporting error." Medicare wanted data from 616 of the ACO's diabetes patients. Of those 616, John Muir Health reported 543 as having no blood pressure reading. For the 73 patients who did have blood pressure reported, 52 were below Medicare's target, meaning the ACO really had a success rate of more than 70 percent, according to Ben Drew, a spokesman for John Muir Health.

Results were similar for the measure on diabetes patients' blood sugar levels. The average ACO rate was 65 percent. But a Wisconsin ACO formed by Bellin Health and ThedaCare had a success rate of 84 percent, and the Accountable Care Coalition of Maryland had just 24 percent of its patients' blood sugar controlled, KHN found.

ACOs also varied widely on the heart disease quality metric, prescribing medicine to improve the pumping action of the heart. Brown & Toland Physicians in San Francisco performed the best, as 97 percent of their patients were prescribed one of the two medications. The average rate for all ACOs was 70 percent.

"A lot of these ACOs are pretty new at this. Not only are they trying to figure out how to manage care, they're figuring out how to work together," David Muhlestein, PhD, director of research with Leavitt Partners, told KHN.

Note: This article was updated Feb. 27 to reflect new information obtained from John Muir Health.

More Articles on Accountable Care Organizations:
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For Some ACOs, It's "No Hospitals Allowed"

 

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