A primary component of the Affordable Care Act (ACA) victoriously saved Medicare $345 each person in medical costs in its 1st year without driving up prescription drug coverage costs, in accordance to an analysis led by the University Of Pittsburgh Graduate School Of Public Health. Released in the journal Medical Care, the research is the 1st to look at how the Accountable Care Organizations (ACOs) model impacted the Medicare Part D prescription drug spending and use in the year of 2012, the first year the ACO model was executed in Medicare.
In the Accountable Care Organizations, a group of providers is collectively accountable for overall charges and the quality of care for a defined group of sufferers. Providers’ payments are aligned with their performance in making better the quality and decreasing costs, giving them incentives to give integrated and coordinated care and effective low-cost treatments to improve patient outcome.
“We discovered that Medicare beneficiaries with Part D prescription coverage with 6 or more chronic conditions who were aligned to an ACO had the greatest savings on medical costs — $966 per sufferer in the year of 2012, compared to their peers not assigned to an ACO,” stated lead author Yuting Zhang, Ph.D., associate professor of health policy and management at Pitt Public Health. “This is motivational because it indicates that ACO providers may be prioritizing their concentration on beneficiaries with several chronic conditions.”
Zhang and her collaborators in the Centers for Medicare and Medicaid Services (CMS), Kadin J. Caines, M.P.H., and Christopher A. Powers, Pharm.D., compared outcomes for 316,366 Medicare Part D beneficiaries aligned with an ACO in the year of 2012 to a random sample of 559,241 similar Medicare beneficiaries not in an ACO during the similar time period.
For each group, the research group looked at per person total yearly Part D spending, total 30-day prescription drug counts, percent of brand name drugs, and total annual Part A and Part B (hospital and medical insurance) spending, involving all non-drug claims.
Being in Accountable Care Organizations didn’t significantly affect sufferers’ Part D spending, total prescriptions filled or the percent of claims for brand name drugs. While it is possible that the impact of ACOs on Part D spending and use is highly restricted to specific classes of drugs, teasing this apart was beyond the scope of the analysis.
“In the future, we will require evaluating the effect of medication prescribing and adherence on clinical outcomes for sufferers in ACOs compared to their peers who are not in ACOs,” said Zhang. “For instance, we could link changes in medication adherence for cardiovascular drugs with heart attacks to observe if there is an obvious difference in prescribing practices and patient outcomes.”
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