What Value Do Teaching Hospitals Provide Commercial Beneficiaries When in an ACO?

AJMC September 16, 2024
Matthew C. Baker, PhD, Theresa R. F. Dreyer, MPH, Matthew C. Baker, PhD, Theresa R. F. Dreyer, MPH, Erin Naomi Hahn, MPH, Keith A. Horvath, MD

Accountable care organizations (ACOs) with a major teaching hospital were associated with lower mortality, lower inpatient spending, lower emergency department utilization, and higher overall outpatient spending.

ABSTRACT

Objectives: The number of commercial beneficiaries cared for by accountable care organizations (ACOs) is growing, but the literature examining their trends is nascent.

Study Design: We examined commercial claims data from 2019 to 2021 to compare beneficiaries attributed to participants in Medicare Shared Savings Program ACOs with and without a major teaching hospital.

Methods: We calculated mortality and spending by setting for each ACO type by year.

Results: Compared with per-beneficiary rates at nonteaching ACOs, major teaching ACOs have lower mortality rates by up to 2.2 percentage points depending on the patient age...

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