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Prevention suffers when doctors drop out of Medicare’s ACO program

Prevention suffers when doctors drop out of Medicare’s ACO program

February 3, 2022Kara GavinMHealth LabMedicare, MA, MSSP, & Medicare ACOs

For 10 years, the agency that runs Medicare has offered doctors and their practices extra money if they joined groups called Accountable Care Organizations and improved the quality of care they provided to older patients covered by traditional Medicare, while also focusing on the cost of their care.

But a new study finds that those quality gains erode quickly when physician groups leave ACOs – which many have done in the past two years. After they dropped out, their patients with diabetes were less likely to get important preventive services, such as screening for high blood sugar or high cholesterol, and eye exams to check for the damage their disease can do.

The new findings were published in JAMA Health Forum just before the release of new data about this year’s ACO enrollment by the Centers for Medicare and Medicaid Services.

The new study’s lead author, Yajuan Si, Ph.D., of the University of Michigan Institute for Social Research, noted, “While more than 11 million older Americans receive care from at least one of the 529,000 physicians or other providers who take part in any one of 483 ACOs, those numbers are down from peaks in 2020. Our findings highlight the need to monitor quality at exiting practices.”

Full Article

: ACOs, Medicare, MSSP, physicians

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