Value-Based Care News

Patient Satisfaction Grows With Accountable Care Organizations

By Ryan Mcaskill

A new study found that beneficiaries are more satisfied with their care following a year with Accountable Care.

- One of the biggest changes to healthcare in the last few years, has been the growth of Accountable Care Organizations (ACOs). This is a Medicare payment reform component of the Affordable Care Act, designed to improve the patient experience, increase quality of care and reduce healthcare spending. According to a new study, after one year, beneficiaries are reporting improved satisfaction with their care.

There are two ACO programs, the Pioneer program and the Medicare Shared Savings Program, which were launched with the ACA in 2012. They have expanded rapidly and now serve an estimated 5.6 million Medicare beneficiaries or about 11 percent of the Medicare population.

The study was conducted by researchers in the Harvard Medical School Department of Health Care Policy.The organization examined Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data covering the three years before and one year after the start of Medicare ACO contracts in 2012 as well as linked Medicare claims. Then the researched compared patients’ experiences in a group of 32,334 fee-for-service beneficiaries attributed to ACOs to a control group of 251,593 attributed to other providers. Patient experiences were examined both before and after the creation of ACOs.

“As payment moves away from fee-for-service toward incentives to limit healthcare spending, we found no evidence of deteriorating patient experiences in ACOs. In fact, ACOs achieved meaningful improvements for patients in some key areas,” said lead author of the study J. Michael McWilliams, associate professor of healthcare policy and medicine at HMS and Brigham and Women’s Hospital. “The improvements that we found in patient experiences constitute important initial progress in fostering high-quality, patient-centered care in Medicare.”

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  • The improvements were concentrated in areas where organizations more easily modify though the implementation of new scheduling referral or information systems. This includes more timely access to care, perceived coordination and access to medical information. The greatest area of improvement was seen with patients with multiple illnesses.

    On the other side of the coin, there was no significant improves in how ACO patients rated individual physicians of their physicians’ communication skills.

    McWilliams added that while these early findings are encouraging, it could be better. Data from the Centers for Medicare and Medicaid Services, suggests modest financial savings can be achieved. This means ACOs might be a viable way to realize benefits for patients while controlling spending.

    “There is a pressing need for regulatory and legislative changes to strengthen ACO incentives, expand provider participation in new payment models and address potential downsides of provider integration, such as higher prices,” McWilliams said. “Our study suggests a promising start, but there is a long road ahead.”