Outcomes for Hospitals Participating in More- and Less-Mature ACOs

AJMC June 13, 2025
Askar Chukmaitov, MD, PhD, David W. Harless, PhD, David B. Muhlestein, PhD, JD

As accountable care organizations’ (ACOs) maturity increased, hospitals participating in CMS ACOs were making progress toward enhanced performance but required more time to improve cost and quality outcomes.

ABSTRACT

Objective: This study examines the impact of accountable care organization (ACO) maturity on inpatient costs, quality of care, and patient safety for hospitals participating in ACOs initiated by CMS relative to nonparticipants.

Study Design: Quasi-experimental evaluation of hospitals before and after joining a CMS ACO using a difference-in-differences design during the period from 2010 to 2013.

Methods: Propensity score–matched groups of hospitals were used to estimate the combined effects of ACO maturity and CMS ACO participation on inpatient costs, quality, and patient safety outcomes. Total treatment costs, mortality rates for 4...

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