Assessing the Ability of Accountable Care Organizations to Reduce the Need for High-Cost Care for the Sickest

This comprehensive evaluation will help determine whether accountable care organizations (ACOs) are improving outcomes and reducing costs for the sickest and frailest Medicare beneficiaries. For each ACO, the research team will link Medicare claims information with a unique set of survey data to determine which ACO characteristics are associated with positive impact. The team also will compare use of acute care providers (hospitals) and postacute care providers (e.g., skilled nursing facilities) before and after implementation of the ACO. Twenty ACOs that have reduced their care costs while maintaining quality will be selected for in-depth study to identify the reasons behind their high performance. The findings will be of value to Medicare in refining its ACO programs and to private-sector ACOs that are seeking to rein in institutional care.