JAMA report findings support integrated, risk-sharing ACOs, authors say

Larger independent physician groups with “strong primary-care orientations” and where doctors have accepted greater financial risk deliver better quality care for Medicare beneficiaries at lower cost, according to a report in JAMA Internal Medicine.

Researchers with Harvard Medical School's healthcare policy department studied 2009 Medicare claims for almost 4.3 million beneficiaries and compared spending and quality measures for small (one to 10 doctors), medium-to-large and hospital-based physician groups. Quality measures included 30-day hospital readmissions, and mammography, diabetes and cholesterol screening for the appropriate patients.Larger, hospital-based groups had higher spending and 30-day readmission rates than smaller groups, the researchers found. But large, independent groups performed better on the process measures and spent less per beneficiary—especially in counties where physician risk sharing was more common. Hospital-based groups with strong primary-care orientations, however, spent less and scored better on readmission and diabetes care measures than their hospital-based counterparts with less emphasis on primary care.

Follow Andis Robeznieks on Twitter: @MHARobeznieks


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