Medicare Data Show Wide Differences In ACOs’ Patient Care

Networks of doctors and hospitals set up under the Affordable Care Act to improve patients' health and save money for Medicare are having varying rates of success in addressing their patients’ diabetes and heart disease, according to government data released Friday. 

The release is the first public numbers from Medicare of how patient care is being affected by specific networks. These accountable care organizations, or ACOs, are among the most prominent of Medicare’s experiments in changing the ways physicians and health care facilities work together and are paid. The ACOs will be able to keep some of the money they save, but they also take on some of the financial risk if their patients end up being costly. 

To make sure the ACOs are not stinting on care in their quests to earn bonuses, Medicare is tracking 33 different quality measures. These look at how well doctors coordinate with each other, whether patients receive appropriate preventive services, whether they suffer unnecessary harm and how patients experience their treatments. 

On Friday, the Centers for Medicare & Medicaid Services (CMS) released data on five of these measures for 141 ACOs during 2012. Four evaluate how well the ACOs helped patients with diabetes. The fifth examined how many patients with arteries packed with plaque received appropriate medicines to relax their blood vessels. Medicare said it did not release more measures because it did not think some of them could be easily understood by consumers or would be useful. Other measures, such as ones about cholesterol levels, were not released because the clinical standards have changed. 

The measures that were released on Medicare's physician compare website account for only 7 percent of the potential savings the ACOs may be able to earn starting next year, said David Muhlestein, director of research at Leavitt Partners, a consulting group.