- What explains the lower medical spending associated with Accountable Care Organizations (ACOs)?
- What is a promising strategy for selecting participants for a care management program?
This resource examines the impact of participation in a Pioneer ACO and its care management program on emergency department (ED) visits, hospitalizations, and Medicare spending.
- The care management program was the ACO’s primary strategy for achieving its cost and quality goals under the Pioneer ACO program.
- The program targeted participants who, based on information from their primary care physicians, were at elevated risk for future spending but whose risk appeared to be modifiable.
- For participants, rates of ED visits were reduced by 6 percent, hospitalizations were reduced by 8 percent, and Medicare spending was reduced by 6 percent.
- Targeting beneficiaries with modifiable high risks and shifting care away from the ED represent viable mechanisms for altering spending within ACOs.