Medicare Accountable Care Organizations Not Linked to Lower Hospital Mortality Rates

Issue 637
AHRQ News Now is a weekly newsletter that highlights agency research and program activities.
October 23, 2018

AHRQ Stats: Prevalence of Health Care Systems

In 2016, about 70 percent of all hospitals were in health systems. Those hospitals accounted for about 88 percent of all beds and 92 percent of all discharges. (Source: AHRQ, 2017 National Healthcare Quality and Disparities Report.)

Today's Headlines:

Medicare Accountable Care Organizations Not Linked to Lower Hospital Mortality Rates

Hospitals that are part of Medicare accountable care organizations (ACOs) may not have lower death rates for preventable conditions compared with hospitals that aren’t part of these ACOs, an AHRQ-funded study concluded. ACOs are groups of hospitals, physicians, health professionals and facilities that provide a range of coordinated services for a patient population. They have grown rapidly in recent years, especially Medicare ACOs, which are allowed under the Affordable Care Act. In this study, AHRQ researchers used the Agency’s Healthcare Cost and Utilization Project to analyze 2008-2014 discharge data from 34 states to compare mortality outcomes between Medicare ACOs and hospitals that did not join ACOs. They tracked outcomes for four conditions for which death is considered preventable with high-quality inpatient care: acute myocardial infarction, coronary artery bypass grafting, pneumonia, and abdominal aortic aneurysm repair. Researchers found that Medicare ACO and non-ACO hospitals had similar death rates for all conditions, suggesting that ACOs may not be improving quality across a full range of care needs. Access the abstract of the study published in the journal Inquiry. 

Long-Term Care Facilities Invited To Join Free Antibiotic Stewardship Program

Register now to attend a one-hour webinar that explains how long-term care facilities can run an effective antibiotic stewardship program by joining a free, 12-month national project. Beginning in December, the AHRQ Safety Program for Improving Antibiotic Use will provide participating long-term care facilities with antibiotic use guidelines, expert coaching, online education, improvement tools and patient education materials to help prevent harms associated with antibiotics, such as Clostridium difficile. Participants also have the opportunity to earn continuing education credits. Learn more about the project by registering for one of three upcoming webinars: Oct. 30, 12:30 p.m. ET; Nov. 1, 10:30 a.m. ET; or Nov. 7, 3:30 p.m. ET. Contact antibioticsafety@norc.org for questions. 

New AHRQ Views Blog Post—A Fresh Look at the Data Shows Patient Safety Improving Overall, With Improvement Still Needed in Many Areas

Jeffrey Brady, M.D., M.P.H., director of AHRQ’s Center for Quality Improvement and Patient Safety, and Karen Chaves, M.H.S, Director of AHRQ’s National Healthcare Quality and Disparities Report Program, highlight data in the newly released Chartbook on Patient Safety. The Chartbook, based on AHRQ’s recently released National Healthcare Quality and Disparities Report, shows that the nation’s efforts to improve the safety of health care resulted in some encouraging overall gains between 2000 and 2016. However, there is much room for improvement, particularly for people of color and people in poor households. The Chartbook findings also identify ongoing safety concerns. Quantifying these challenges provides essential information to inform future quality improvement efforts. Access the blog post.

Informational Webinars Start Oct. 29 for AHRQ Project on Learning How To Enhance Surgical Care and Recovery

Get help implementing an enhanced surgical recovery program for your hospital’s gynecology, colorectal, hip fracture or joint replacement surgery service by enrolling in a no-cost program that is funded and guided by AHRQ. Enrollment is open for the 12-month program that starts March 1, 2019. Informational webinars begin on Oct. 29 and run through Dec. 13. Hospitals participating in the program will receive evidence-based information on improving patients' recovery from surgery, coaching and content calls with experts in the field, implementation resources, access to the American College of Surgeons’ data collection platform and benchmark reports, and continuous clinical and implementation support. These resources are invaluable to help kick-start and sustain an enhanced recovery program at your hospital. The Johns Hopkins Armstrong Institute for Patient Safety and Quality, in collaboration with the American College of Surgeons, is leading the program. Several free informational webinars are available for hospitals interested in joining or learning more. Visit the program’s Web site for webinar dates, details and registration information. 

Highlights From AHRQ’s Patient Safety Network

AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:

Review additional new publications in PSNet’s current issue or access recent cases and commentaries in AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).

Now Available: Updated National Database of Medicare Providers

A database used by researchers to identify Medicare providers and their affiliations with medical practices has been updated to include information from 2016. The Medicare Data on Provider Practice and Specialty file, which covers the years 2009 to 2016, provides information on more than 640,000 physicians and 430,000 non-physician clinicians. Providers and their practices are identified based on National Provider Identifier numbers and tax identification numbers. As of this year, the database has information on where each provider practices (e.g., office or inpatient hospital).  Researchers may apply for a data use agreement to obtain copies of the file. Access more information or contact pete.welch@hhs.gov or alshadye.yemane@cms.hhs.gov

Learning Communities Lead to Diffusion of Innovation, Quality Improvement: AHRQ Study

Learning communities, which gather together diverse participants as a strategy to encourage group learning, can accelerate the dissemination and implementation of innovations and ultimately
lead to quality improvement in local health care settings, a new AHRQ study has found. In the study, published in the Joint Commission Journal on Quality and Patient Safety, researchers studied three AHRQ learning communities that were focused on adopting innovations in advancing patient- and family-centered care in hospitals, promoting medication management for high-risk populations, and reducing nonurgent emergency services. They identified lessons related to learning community startup (recruitment and goal setting); learning community operations (engagement, collaborative decision-making, and sustainability); and innovation implementation (changing care delivery processes and/or policies). Access the abstract of the study.

AHRQ in the Professional Literature

Population-based assessment of complications following surgery for thyroid cancer. Papaleontiou M, Hughes DT, Guo C, et al. J Clin Endocrinol Metab 2017 Jul 1;102(7):2543-51. Access the abstract on PubMed®.

The modified frailty index to predict morbidity and mortality for retroperitoneal sarcoma resections. Park JS, Bateni SB, Bold RJ, et al. J Surg Res 2017 Sep;217:191-7. Epub 2017 May 11. Access the abstract on PubMed®.

Early hospital readmission among hemodialysis patients in the United States is associated with subsequent mortality. Plantinga LC, King L, Patzer RE, et al. Kidney Int 2017 Oct;92(4):934-41. Epub 2017 May 20. Access the abstract on PubMed®.

Use of simulation based on an electronic health records environment to evaluate the structure and accuracy of notes generated by medical scribes: proof-of-concept study. Pranaat R, Mohan V, O'Reilly M, et al. JMIR Med Inform 2017 Sep 20;5(3):e30. Access the abstract on PubMed®.

Family perspectives on telemedicine for pediatric subspecialty care. Ray KN, Ashcraft LE, Mehrotra A, et al. Telemed J E Health 2017 Oct;23(10):852-62. Epub 2017 Apr 21. Access the abstract on PubMed®.

Utilization of apical vaginal support procedures at time of inpatient hysterectomy performed for benign conditions: a national estimate. Ross WT, Meister MR, Shepherd JP, et al. Am J Obstet Gynecol 2017 Oct;217(4):436.e1-436.e8. Epub 2017 Jul 14. Access the abstract on PubMed®.

Are informed policies in place to promote safe and usable EHRs? A cross-industry comparison. Savage EL, Fairbanks RJ, Ratwani RM. J Am Med Inform Assoc 2017 Jul 1;24(4):769-75. Access the abstract on PubMed®.

Developing a clinician friendly tool to identify useful clinical practice guidelines: G-TRUST. Shaughnessy AF, Vaswani A, Andrews BK, et al. Ann Fam Med 2017 Sep;15(5):413-8. Access the abstract on PubMed®.

Contact Information

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Page last reviewed October 2018
Page originally created October 2018
Internet Citation: Medicare Accountable Care Organizations Not Linked to Lower Hospital Mortality Rates. Content last reviewed October 2018. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsletters/e-newsletter/637.html
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