Non-ACO hospitals outperform ACOs in some value-based initiatives

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Hospitals that participate in an ACO do not necessarily  perform better that their non-ACO peers in all Medicare value-based programs, according to a recent study in the American Journal of Managed Care.

Using Medicare's value-based purchasing performance data and Leavitt Partners' ACO data, the study compared VBP scores for hospital ACOs compared to non-ACO hospitals. Researchers then analyzed VBP scores for hospitals that became part of an ACO during the second year of performance data as well as hospitals that never became part of an ACO. Data spanned 2013 to 2016.

Here are three study findings.

1. Between 2013 and 2016, hospitals in ACOs performed better than non-ACO hospitals in CMS' Hospital Readmissions Reduction Program by a factor of 0.72.

2. During the same period, non-ACO hospitals outperformed hospital ACOs in Hospital Value-Based Purchasing and Hospital-Acquired Condition Reduction programs by a statistical significance factor of 0.001. When researchers adjusted for specific hospital attributes, such as number of beds, ownership and teaching status, non-ACO hospitals fared better by a factor of 0.62 for the HVBP program and 0.28 for the HACR program.

3. "Despite similar goals, hospital participation in an ACO is not correlated with improved performance in all Medicare VBP programs," the study concluded.

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