Reports from Center for Outcomes Research and Evaluation Highlight Recent Findings in Managed Care (ACO-Level Administrative Claims-Based Measure of Days At Home for Patients With Complex Chronic Conditions): Managed Care

2025 DEC 04 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Current study results on Managed Care have been published. According to news reporting from New Haven, Connecticut, by NewsRx journalists, research stated, “Stakeholders have called for measures of how much time patients spend at home and in the community to incentivize coordinated, timely, and primary care-based services and reduce unnecessary acute care. We developed a claims-based ‘Days at Home’ Accountable Care Organization (ACO) measure for Medicare beneficiaries, intended to assess the number of days in a calendar year that adults with complex chronic disease spend at outside acute or postacute inpatient facilities.”

The news correspondents obtained a quote from the research from Center for Outcomes Research and Evaluation, “Testing used 2017 and 2018 Medicare claims for fee-for-service patients enrolled in 610 Shared Savings Program ACOs. We used a split-half method for reliability testing, and a survey of technical experts and comparison to related measures for validity. The measure adjusts for 51 clinical and demographic variables and one social determinant of health (Medicaid dual-eligibility). To avoid unintended consequences of discouraging medically appropriate care and excessive reliance on nursing homes, the measure adjusts for mortality and new admissions to long-term nursing home care. The cohort (N=1,154,779) was predominantly White (84.9%) and aged 65 years or older (84.0%), and 22.8% were Medicaid dual-eligible. Mean ACO-level adjusted days at home was 330.4, ranging from 291.0 to 345.9 days (interquartile range: 329.1-332.1). Split-sample reliability was 0.833. External experts rated the measure as having face validity; in assessing external validity the measure generally correlated with related measures.”

According to the news reporters, the research concluded: “The Days at Home ACO measure is a reliable and valid measure that can be used to promote coordinated and prevention-focused home-based and community-based care.”

This research has been peer-reviewed.

For more information on this research see: ACO-Level Administrative Claims-Based Measure of Days At Home for Patients With Complex Chronic Conditions. Medical Care, 2025. Medical Care can be contacted at: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA. (Lippincott Williams and Wilkins - www.lww.com; Medical Care - http://journals.lww.com/lww-medicalcare/pages/default.aspx)

Our news journalists report that additional information may be obtained by contacting Yongfei Wang, Yale New Haven Health Services Corporation, Center for Outcomes Research and Evaluation (YNHHSC, CORE), New Haven, CT. Additional authors for this research include Kyle Bagshaw, Zhenqiu Lin, Jeph Herrin, Aruna Jhasti and Kelly Kyanko.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1097/mlr.0000000000002255. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

Publisher contact information for the journal Medical Care is: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA.

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