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Evaluating the Effects of Pioneer Accountable Care Organizations on Medicare Part D Drug Spending and Utilization

Datos Bibliográficos

ID9103087
AutoresYuting Zhang (0000-0002-6460-6779, University of Pittsburgh, autor de correspondencia), Kadin J Caines (Centers for Medicare and Medicaid Services, Office of Enterprise Data and Analytics, Baltimore, MD), Kadin Caines (Centers for Medicare and Medicaid Services), Christopher A Powers (Centers for Medicare and Medicaid Services, Office of Enterprise Data and Analytics, Baltimore, MD)
Año2017
Volumen55
Número5
Páginas470-475
Fecha de publicación2017-05-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000686
PMID28060052
OpenAlexW2569297303
IdiomaEN
Citas recibidas3
Referencias citadas22

BACKGROUND: The improvement of medication use is a critical mechanism that accountable care organization (ACO) could use to save overall costs. Currently pharmaceutical spending is not part of the calculation for ACO-shared savings and risks. Thus, ACO providers may have strong incentives to prescribe more medications hoping to avoid expensive downstream medical costs. METHODS: We designed a quasinatural experiment study to evaluate the effects of Pioneer ACOs on Medicare Part D spending and utilization. Medicare fee-for-service beneficiaries with Part D drug coverage who were aligned to a Pioneer ACO were compared with a random 5% sample of non-ACO beneficiaries. Outcomes included changes in Part D spending, number of prescription fills, percent of brand medications, and total Part A and B medical spending. We utilized a generalized linear model with a difference-in-differences approach to estimate 2011-2012 changes in these outcomes among beneficiaries aligned with Pioneer ACOs, adjusting for all beneficiary-level demographics, income and insurance status, clinical characteristics, and regional fixed effects. RESULTS: Being in an ACO did not significantly affect Part D spending (-$23.52; P=0.19), total prescriptions filled (-0.12; P=0.27), and the percent of claims for brand-name drugs (0.06%; P=0.23). The ACO group was associated with savings in Parts A and B spending of $345 (P<0.0001) per person per year. CONCLUSIONS: We found that beneficiaries aligned to Pioneer ACOs were not associated with changes in pharmaceutical spending and use, but were associated with savings in Parts A and B spending in 2012

Business · Drug · Family medicine · MEDLINE · Political science · Healthcare Policy and Management · Medication Adherence and Compliance · Medicine · Pharmaceutical Economics and Policy · Pharmacology

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Obras citantes distintas3
Citas por año0,43
Intervalo de citas2019 - 2022 (4)
Velocidad de citaciónhistorical
Altamente citadoNo
Tipos de citaNeutras: 2
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