Medicare Accountable Care Organization Enrollment and Appropriateness of Cancer Screening

JAMA Network March 19, 2018
Matthew J. Resnick, MD, MPH, MMHC; Amy J. Graves, SM, MPH; Sunita Thapa, MPH; Robert Gambrel, MA; Mark D. Tyson, MD; Daniel Lee, MD; Melinda B. Buntin, PhD; David F. Penson, MD, MPH, MMHC, FACS

Question Does Medicare Accountable Care Organization (ACO) enrollment drive changes in appropriateness of screening for breast, colorectal, and prostate cancer?

Findings In this population-based analysis, Medicare ACO enrollment resulted in significant improvements in appropriateness of breast and colorectal cancer screening, namely improving screening rates among those likely to benefit and withholding screening from those unlikely to benefit. Conversely, ACO enrollment was associated with significant reductions in prostate cancer screening regardless of age or predicted survival.

Meaning Widespread diffusion of alternative payment models may improve the quality of breast and colorectal cancer screening programs by targeting screening to those likely to benefit and withholding screening from those who are not.

Importance Despite rapid diffusion...

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