Table 5.
Adjusted Change in Outcomes after a Hospital or Post‐Acute Care Provider Joined an ACO
| Skilled Nursing Facility Cohort (n = 3,503,296) | ||||
|---|---|---|---|---|
| Hospital in ACO | Hospital and Skilled Nursing Facility in ACO | |||
| Absolute Change [95% CI] | p‐Value | Absolute Change [95% CI] | p‐Value | |
| 30‐day readmission or mortality (%) | −0.5 [−0.9 to −0.1] | .008 | −1.7 [−3.2 to −0.2] | .03 |
| 30‐day mortality (%) | −0.1 [−0.4 to 0.2] | .53 | −0.6 [−1.9 to 0.7] | .34 |
| Medicare spending on total episode ($) | −184 [−317 to −51] | .007 | −1,614 [−2,380 to −848] | <.001 |
| Medicare spending on hospitalization ($) | −59 [−140 to 22] | .16 | −161 [−358 to 35] | .11 |
| Medicare spending on PAC ($) | 23 [−56 to 101] | .57 | −940 [−1,517 to −363] | .001 |
| Length of stay in total episode (days) | −0.0 [−0.2 to 0.2] | .86 | −3.1 [−4.3 to −2.0] | <.001 |
| Length of stay in hospital (days) | 0.0 [−0.0 to 0.1] | .78 | 0.1 [−0.1 to 0.4] | .35 |
| Length of stay in PAC (days) | 0.1 [−0.1 to 0.2] | .20 | −2.8 [−4.1 to −1.6] | <.001 |
| Home Health Cohort (n = 1,597,751) | ||||
|---|---|---|---|---|
| Hospital in ACO | Hospital and Home Health Agency in ACO | |||
| Absolute Change [95% CI] | p‐Value | Absolute Change [95% CI] | p‐Value | |
| 30‐day readmission or mortality (%) | −0.4 [−0.8 to −0.03] | .03 | −0.4 [−1.1 to 0.3] | .23 |
| 30‐day mortality (%) | −0.1 [−0.3 to 0.1] | .32 | −0.1 [−0.5 to 0.3] | .66 |
| Medicare spending on total episode ($) | −56 [−178 to 65] | .36 | −209 [−431 to 12] | .06 |
| Medicare spending on hospitalization ($) | −45 [−144 to 53] | .37 | −89 [−294 to 116] | .40 |
| Medicare spending on PAC ($) | 46 [19 to 73] | .001 | −38 [−75 to 0] | .05 |
| Length of stay for total episode (days) | −0.1 [−0.5 to 0.2] | .42 | −1.6 [−2.3 to −0.9] | <.001 |
| Length of stay in hospital (days) | 0.0 [−0.1 to 0.0] | .32 | 0.0 [−0.1 to 0.1] | .85 |
| Length of stay in PAC (days) | −0.1 [−0.4 to 0.2] | .52 | −1.6 [−2.2 to −1.1] | <.001 |
| Inpatient Rehabilitation Cohort (n = 445,264) | ||||
|---|---|---|---|---|
| Hospital in ACO | Hospital and Inpatient Rehabilitation Facility in ACO | |||
| Absolute Change [95% CI] | p‐Value | Absolute Change [95% CI] | p‐Value | |
| 30‐day readmission or mortality (%) | −0.4 [−1.3 to 0.4] | .32 | 0.4 [−0.9 to 1.6] | .57 |
| 30‐day mortality (%) | −0.5 [−1.0 to 0.0] | .05 | 0.1 [−0.6 to 0.8] | .74 |
| Medicare spending on total episode ($) | 189 [−212 to 591] | .36 | −62 [−604 to 480] | .83 |
| Medicare spending on hospitalization ($) | 52 [−196 to 301] | .68 | −133 [−363 to 97] | .26 |
| Medicare spending on PAC ($) | 28 [−199 to 255] | .81 | −85 [−470 to 300] | .67 |
| Length of stay in total episode (days) | 0.2 [−0.3 to 0.6] | .41 | 0.5 [−0.1 to 1.2] | .09 |
| Length of stay in hospital (days) | −0.1 [−0.2 to 0.0] | .12 | −0.1 [−0.3 to 0.0] | .15 |
| Length of stay in PAC (days) | 0.1 [−0.1 to 0.3] | .26 | 0.1 [−0.2 to 0.4] | .37 |