Study Findings on Insurance Are Outlined in Reports from Duke University (Using a Home Time Measure To Differentiate Aco Performance for Seriously Ill Populations): Insurance

Health Policy and Law Daily

2022 JUN 17 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- New research on Insurance is the subject of a report. According to news reporting out of Durham, North Carolina, by NewsRx editors, research stated, “Alternative Payment Models (APMs) piloted by the Centers for Medicare and Medicaid Services (CMS) such as ACO Realizing Equity, Access and Community Health (REACH) seek to improve care and quality of life among seriously ill populations (SIP). Days at Home (DAH) was proposed for use in this model to evaluate organizational performance.”

Financial support for this research came from West Health Policy Institute.

Our news journalists obtained a quote from the research from Duke University, “It is important to assess the utility and feasibility of person-centered outcomes measures, such as DAH, as CMS seeks to advance care models for seriously ill beneficiaries. We leverage existing Accountable Care Organization (ACO) contracts to evaluate the feasibility of ACO-level DAH measure and examine characteristics associated with ACOs with more DAH. We calculated DAH for Medicare fee-for-service beneficiaries aged 68 and over who were retrospectively attributed to a Medicare ACO between 2014 and 2018 and met the seriously ill criteria. We then aggregated to the ACO level DAH for each ACO’s seriously ill beneficiaries and risk-adjusted this aggregated measure. Finally, we evaluated associations between risk-adjusted DAH per person-year and ACO, beneficiary, and market characteristics. ACOs’ seriously ill beneficiaries spent an average of 349.3 risk-adjusted DAH per person-year. Risk-adjusted ACO variation, defined as the interquartile range, was 4.21 days (IQR = 347.32-351.53). Beneficiaries of ACOs are composed of a less racially diverse beneficiary cohort, opting for two-sided risk models, and operating in markets with fewer hospital and Skilled Nursing Facility beds had more DAH. Substantial variation across ACOs in the DAH measure for seriously ill beneficiaries suggests the measure can differentiate between high and low performing provider groups. Key to the success of the metric is accurate risk adjustment to ensure providers have adequate resources to care for seriously ill beneficiaries.”

According to the news editors, the research concluded: “Organizational factors, such as the ACO size and level of risk, are strongly associated with more days at home.”

This research has been peer-reviewed.

For more information on this research see: Using a Home Time Measure To Differentiate Aco Performance for Seriously Ill Populations. Journal of the American Geriatrics Society, 2022. Journal of the American Geriatrics Society can be contacted at: Wiley, 111 River St, Hoboken 07030-5774, NJ, USA. (Wiley-Blackwell - http://www.wiley.com/; Journal of the American Geriatrics Society - http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1532-5415)

Our news journalists report that additional information may be obtained by contacting Salama S. Freed, Duke University, Margolis Ctr Hlth Policy, Durham, NC, United States. Additional authors for this research include Brystana G. Kaufman, Courtney H. Van Houtven and Robert Saunders.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1111/jgs.17882. 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.

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