Examination of Accountable Care Organizations and Hospitals in Rural Areas

The experience of Caravan Health, a managed services organization that supports 38 rural ACOs, provides some evidence that rural ACOs are achieving savings and improving quality. To better understand the practices and outcomes achieved by rural ACOs, the research team will first investigate the relationship between an ACO’s presence in a rural area and participating hospitals’ performance on patient outcomes and costs. The team also will conduct a subgroup analysis to determine how rural ACOs perform on quality of care for high‐need, high‐cost patients. Second, as previous research has found that ACOs with embedded care coordinators achieve greater savings than other Medicare ACOs, the researchers will seek to determine whether Caravan’s embedded care coordinators can explain any difference in performance by comparing data before and after the coordinators were added to care teams.