Becker's Hospital Review

24 Clinical Integration & ACOs ACO Success Rates on Quality Measures Vary By Heather Punke I n February, CMS released data on five of the 33 quality measures tracked by 141 accountable care organizations in 2012, revealing that ACOs had varying success controlling patients' diabetes and heart disease. Kaiser Health News performed an analysis of the newly released data, which shows, for example, that ACOs succeeded at keeping diabetes patients' blood pressure below Medicare's target for 67 percent of patients on average. Eighty-eight percent of Minneapolis-based Allina Health's diabetes patients, however, had their blood pressure under the Medicare target of 140/90 mmHg. On the other hand, just 9 percent of patients in John Muir Health's Medicare ACO in Walnut Creek, Calif., held their blood pressure in check. John Muir Health said the low success rate on the diabetic blood pressure metric is due to a reporting error. Results were similar for the measure on diabetes patients' blood sugar levels. The average ACO rate was 65 percent. But a Wisconsin ACO formed by Bellin Health and ThedaCare had a success rate of 84 percent, and the Accountable Care Coalition of Maryland had just 24 percent of its patients' blood sugar controlled, KHN found. ACOs also varied widely on the heart disease quality metric, prescribing medicine to improve the pumping action of the heart. Brown & Toland Phy- sicians in San Francisco performed the best, as 97 percent of their patients were prescribed one of the two medications. The average rate for all ACOs was 70 percent. "A lot of these ACOs are pretty new at this. Not only are they trying to figure out how to manage care, they're figuring out how to work together," David Muhlestein, PhD, director of research with Leavitt Partners, told KHN. n Study: Patient- Centered Medical Home Model Ineffective By Heather Punke A three-year patient-centered medical home pilot program led to few quality gains and no reductions of hospital utilization or to- tal cost of care, a RAND Corp. study found. The Southeastern Pennsylvania Chronic Care Initiative was a medical home pilot involving 32 primary care practices and six health plans that ran between 2008 and 2011. The study compared quality, utilization and costs between pilot practices and 29 nonpilot practices. While pilot practices adopted medical home capabilities, like creating lists of patients overdue for care, and showed signs of quality improvement for aspects of diabetes care, there was no quality improvement for asthma care, cancer screening or control of diabetes. Additionally, the pilot program was unsuccessful at lowering patient visits to hospitals or emergency departments, and there were no cost reductions. Researchers did note that practices participating in the pilot program may have been more quality-minded than others prior to becoming a medi- cal home, meaning there may not have been much room for quality im- provement. "The medical home has gained popularity as a new model of primary care, with the expectation that the approach will produce better and low- er-cost healthcare," Mark Friedberg, MD, the study's lead author and a natural scientists at RAND, said in a release. "Our findings suggest that achieving all of these goals is a challenge." n Becker's Hospital Review 5th Annual Meeting May 15-17, 2014 Swissôtel • Chicago, Illinois For more information visit, www.BeckersHospitalReview.com and click on "Conferences." Joe Torre Forrest Sawyer Barry Arbuckle, PhD Toby Cosgrove, MD Keynote speakers include: The Most Business- and Quality-Focused Meeting in the Hospital and Health System Arena 100+ sessions and 190+ speakers

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