The insurer did not release first-year performance on measures of health spending. “Our goal was improving the healthcare for our members,” Ng said. “We know that savings will follow. We expect we'll see the financial benefit in future years. It's too early to measure the financial goals of a program with such a long tail.”
The ACOs, launched in January 2012, are among a growing number of public and private market efforts to test the payment model. The experiments offer varying degrees of financial incentives tied to performance on quality and control of health spending. Medicare in the past two years has created about 250 accountable care organizations under the Patient Protection and Affordable Care Act. The federally sponsored ACOs have so far released little performance data, though 32 of the most ambitious Medicare ACOs, known as Pioneers, saw mixed results in the first year. Twenty-three Pioneers continued into the second year; two dropped out and the rest switched to a less risky ACO model.
The Anthem Blue Cross ACOs used 13 quality measures, including women ages 42 to 69 who received mammograms within the previous two years and a measure of appropriate antibiotic use.
Mammogram use increased 31%-42% during the ACOs' first year compared with 2011 for all participating medical groups. The rate of correct antibiotic use among bronchitis patients also increased between 13% and 87%.
Ng said the ACOs' second year, which began in January, shifted efforts toward better management of enrollees with at least two chronic diseases. “That's where the costs are,” he said. “It makes sense to focus our efforts to improve their care for those who use the most.”
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