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. 2022 Apr 1;22(2):3. doi: 10.5334/ijic.6002

Table 4.

Summary of included articles. Abbreviations: HMO, Health Maintenance Organization; GP, general practitioner; ED, emergency department; HbA1C, average blood glucose levels for last two to three months; LDL(-C), low-density lipoprotein (cholesterol); SUD, substance use disorder; P4P, Pay-for-performance; SNF, skilled nursing facility; AMI, acute myocardial infarction; COPD, chronic obstructive pulmonary disease; CHF, congestive heart failure; ICU, intensive care unit; IRF, inpatient rehabilitation facility; HHA, home health agency; LTC, long-term care; AAA, abdominal aortic aneurysm; CABG, coronary artery bypass grafting; ACO, Accountable Care Organization; FFS, fee-for-service; DMP, disease management program. SBI; Screening and Brief Intervention (for SUD); PDC, proportion of days covered; ESRD, end stage renal disease; AVR, aortic valve replacement; MSSP, Medicare Shared Savings Program; AQC, Alternative Quality Contract; PGPD, Physician Group Practice Demonstration.

REFERENCE # YEAR FIRST AUTHOR METHOD COUNTRY PROGRAM NETWORK CONFIGURATION PAYMENT MODEL(S) FLOW STUDY POPULATION INTERVENTION N CONTROL N INDICATOR QUALITY OF CARE UTILIZATION SPENDING OTHER EPOC
42 1995 Schlenker QN USA HMO Not specified Capitation To Medicare home health beneficiaries 181 patients 1,079 patients Patient discharge + C2
Home health visits +
Cost per patient +
Episode length +
43 1995 Robinson Mixed USA HMO Integrated physician medical groups in California Capitation To Capitated HMO enrollees in six integrated physician medical groups Not reported Not reported Physician visits – C1
44 2014 Marton QN USA Passport (P) and Kentucky Health Select Plan (K) Primary care practices in regional managed care networks Capitation + P4P (P)
P4P (K)		 In Children enrolled in Medicaid 1,890 patients (P) and 4,273 patients (K) 2,816 patients (P) and 9,317 patients (K) Outpatient utilization (P/K) +/+ B1
Professional utilization (P/K) +/–
45 2017 Mandal QN USA HMO Provider group with 7 clinic locations and 25 primary care specialists Capitation + risk-and-gain sharing To Community-dwelling Medicare Advantage enrollees ≥65 years 1,230 patients 1,230 patients Office-based visits + B1
ED hospital visits +
Inpatient hospital admissions +
30-day readmission 0
60-day readmission 0
Preventive visits +
Screening mammography +
Screening colonoscopy 0
48 2011 De Bakker Mixed NL DMP for diabetes Care groups, consisting of health care providers such as GPs, laboratories, dietitians and medical specialists Disease-based bundled payment To Diabetes patients assigned to care group Not reported (10 care groups) Not reported Collaboration + C4
Process quality +
Transparency +
GP domination of care groups –
Administrative burden –
Price variations –
47 2014 Busse Mixed NL DMP for diabetes Care groups, consisting of health care providers such as GPs, laboratories, dietitians and medical specialists Disease-based bundled payment To Diabetes patients assigned to care group Not reported Not reported Specialist care use + B1
Control of blood pressure and cholesterol +
HbA1C +
Regular check-ups +
Foot exams +
Kidney exams +
Eye testing –
Total medical spending –
46 2015 Mohnen QN NL DMP for diabetes Care groups, consisting of health care providers such as GPs, laboratories, dietitians and medical specialists Disease-based bundled payment To Diabetes patients assigned to care group 20,257 patients 43,754 patients Curative health care spending – B1
49 2021 Karimi QN NL DMP for diabetes, COPD and vascularrisk management (VRM) Care groups, consisting of health care providers such as GPs, laboratories, dietitians and medical specialists Disease-based bundled payment To Patients enrolled in a bundled payment for diabetes, COPD, or increased vascular risk 807,197 patients (diabetes), 1,039,406 (VRM), 267,843 (COPD) 988,480 patients Diabetes total cost – B1
Diabetes medical specialist cost –
Diabetes primary care cost +
Diabetes medication cost –
Diabetes bundled payment cost –
VRM total cost –
VRM medical specialist cost –
VRM primary care cost +
VRM medication cost –
VRM bundled payment cost –
COPD total cost –
COPD medical specialist cost –
COPD primary care cost +
COPD medication cost –
COPD bundled payment cost –
50 2021 Navathe QN USA MSSP Not specified Disease-based bundled payment In Medicare fee-for-service beneficiaries 24,884 patients 70,208 patients Post discharge institutional spending medical episode (non-ACO/ACO) +/+ B1
Medical episode mortality (non-ACO/ACO) 0/0
Medical episode 90-day readmissions (non-ACO/ACO) 0/+
Medical episode discharge to SNF/IRF (non-ACO/ACO) 0/0
Medical episode discharge to HH (non-ACO/ACO) +/+
Medical episode length of stay SNF (non-ACO/ACO) +/+
Post discharge institutional spending surgical episode (non-ACO/ACO) +/+
Surgical episode mortality (non-ACO/ACO) 0/0
Surgical episode 90-day readmissions (non-ACO/ACO) +/+
Surgical episode discharge to SNF/IRF (non-ACO/ACO) +/+
Surgical episode discharge to HH (non-ACO/ACO) +/+
Surgical episode length of stay SNF (non-ACO/ACO) +/+
52 2007 Mandel QN USA Not specified Physician-hospital organization consisting of primary care practices (PCPs) P4P To/in Children with asthma 13,380 patients in 44 PCPs Not reported Perfect care delivery + C3
Influenza vaccination rates +
51 2006 Levin-Scherz QN USA Partners Community HealthCare (PCHI) Network composedof 15 regional service organizations P4P To PCHI patients Variedper measure Variedper measure HbA1C screening + B1
Diabetic LDL screening +
Nephropathy screening +
Diabetic eye exams +
Paediatric asthma controller use 0
53 2010 Atkinson QN USA Long Island Health Network Clinically integrated network of 10 hospital facilities P4P In Not specified Not reported Not reported Quality (overall composite measure) + C3
Hospital average length of stay +
54 2018 Rieckmann Mixed USA Coordinated Care Organization Integrated financing and service delivery for medical, behavioural, and dental health P4P In Members enrolled in CCO Not specified Not specified SUD screening + C1
SUD treatment initiation –
SUD treatment engagement –
55 2015 Hibbard Mixed USA Fairview Pioneer ACO PCPs working in a Pioneer accountable care organization P4P In Fairview PCPs 85 respondents Not applicable Efforts into increasing patient activation and patient self-management 0 C3
Becoming more patient-centred 0
56 2016 Gleeson QN USA Partner for Kids Physicians in a paediatric accountable care organization P4P In Community physicians who received P4P incentives 203 physicians across 50 practices 2763 physicians across 82 practices Adolescent well care visits + B1
Well child visits at 3–6 years1 +/0
Asthma at 12–18 years 0/0
Asthma at 5–11 years 0/0
Immunizations (adolescents) 0/–
Meningococcal immunizations (adolescents) 0/–
Td/Tdap immunizations (adolescents) 0/–
Immunizations (children) 0/–
DTP immunizations (children) +/–
Hepatitis A immunizations (children) 0/–
IPV immunizations (children) +/–
MMR immunizations (children) 0/0
Pneumococcal conjugate immunizations (children) +/0
Varicella immunizations (children) 0/–
Pharyngitis 0/0
Upper respiratory infection 0/0
ADHD maintenance 0/0
ADHD initiation 0/0
Lead screening +/0
Influenza 0/0
Rotavirus +/–
57 2020 Ganguli QN USA MSSP Not specified P4P In ACOs using cost reduction-based specialist compensation (P4P) 41 ACOs 119 ACOs Shared savings 0 B2
Outpatient spending 0
Specialist visits 0
115 2017 Afendulis Mixed USA Total Cost and Care Improvement (TCCI) Primary care physician panels, consisting of at least 5-15 physicians and 1000 patients Global payment + shared savings + pay-for-coordination To CareFirst BlueCross BlueShield Total Care and Cost Improvement Program enrollees 298,463 patients 537,778 patients Outpatient spending 0 B1
Specialist visits 0
Primary care visits 0
Inpatient spending 0
Outpatient spending 0
Total spending 0
103 2017 Stuart QN USA AQC Not reported Global payment + P4P + shared savings To BCBSMA HMO and POS (point of service) plan enrollees 10,817 patients 50,576 patients SUD service utilization 2 0/+ B1
SUD spending 0/0
SUD identification 0/+
SUD initiation 0/+
SUD engagement 0/0
106 2013 McWilliams QN USA AQC Not reported Global payment + P4P + shared savings To Elderly FFS Medicare beneficiaries in Massachusetts treated by AQC-affiliated providers 417,182 person-years 1,344,143 person-years Total spending + B1
Admission rate for ambulatory care–sensitive conditions related to cardiovascular disease or diabetes 0
30-day readmission 0
Mammography screening 0
LDL-C testing (diabetes and cardiovascular) +
HbA1C testing 0
Diabetes retinal examination 0
107 2011 Song QN USA AQC Not reported Global payment + P4P + shared savings To Enrollees whose PCPs were in the AQC system 380,142 enrollees 1,351,446 enrollees Medical spending + B1
Paediatric care quality +
Adult preventive care quality 0
Chronic care management quality +
108 2012 Song QN USA AQC Not reported Global payment + P4P + shared savings To BCBSMA enrollees 612,547 enrollees 1,339,798 enrollees Medical spending + B1
Paediatric care quality +
Adult preventive care quality +
Chronic care management quality +
109 2014 Song QN USA AQC Not reported Global payment + P4P + shared savings To Persons in four cohorts of AQC organizations, defined by first contract year: 2009, 2010, 2011, 2012 1,348,235 enrollees 966,813 enrollees Medical spending + B1
Chronic disease management quality +
Adult preventive care quality +
Paediatric care quality +
104 2016 Huskamp QN USA AQC Not reported Global payment + P4P + shared savings To Adults between 18–64 years enrolled in BCBSMA HMO or POS (point of service) plans 533,568 person-years 2,999,221 person-years Any tobacco cessation treatment use + B1
Varenicline or bupropion use +
Nicotine replacement therapy use 0
Tobacco cessation counselling visit use +
Combination therapy (pharmacotherapy plus counselling) use +
≥90-day supply of tobacco cessation +
112 2014 Afendulis QN USA AQC Not reported Global payment + P4P + shared savings To BCBSMA HMO and POS (point of service) plan enrollees 332,624 enrollees 1,296,399 enrollees Drug utilization 0 B1
Drug spending 0
113 2018 Donohue QN USA AQC Not reported Global payment + P4P + shared savings To Individuals with alcohol use disorders (AUD) and/or opioid use disorders (OUD) 8,956 person-years 40,884 person-years Medication treatment use 0 B1
110 2014 Chien QN USA AQC Not reported Global payment + P4P + shared savings To BCBSMA HMO enrollees 0-21 years with and without special health care needs (CSHCN) 126,975 enrollees 415,331 enrollees Quality measures tied to P4P + B1
Quality measures not tied to P4P 0
Medical spending 0
111 2017 Pimperl QN DE Gesundes Kinzigtal Not reported Global payment + P4P + shared savings To Gesundes Kinzigtal enrollees Varied per measure Varied per measure Mortality rate 0 B1
Average age at time of death +
Years of potential life lost +
105 2012 Hildebrandt QN DE Gesundes Kinzigtal Population-wide integrated care system that covers all sectors and indications of care with a group of providers Global payment + P4P + shared savings To Gesundes Kinzigtal enrollees Varied per measure Varied per measure Hospitalization + B1
Medical spending +
114 2017 Blewett Mixed USA Integrated Health Partnership Minnesota Integrated health partnerships deliver the full scope of primary care services, and coordinate access to specialty providers and hospitals Global payment + P4P + shared savings To Minnesota Health Care Program enrollees Not reported Not reported Forging of community partnerships + C4
Service integration +
58 2014 Sandberg Mixed USA Hennepin Health Hennepin County Human Services and Public Health Department; Hennepin County Medical Center, NorthPoint Health and Wellness Center, Metropolitan Health Plan (HMO), all covering physical, behavioural and social services. Global payment + shared savings To Adults without dependent children Not reported Not reported ED visits + C3
Outpatient visits +
Hospitalization 0
Patients receiving optimal diabetes, vascular and asthma care +
41 2017 Narayan QN USA MSSP Not reported Global payment + shared savings To Medicare beneficiaries in ACOs 5,329,831 beneficiaries Not reported Mammography screening use + C1
40 2018 Fraze QN USA MSSP Not reported Global payment + shared savings To MSSP ACOs 162 ACOs Not reported All-or-nothing diabetes composite + C1
HbA1C controlled +
LDL controlled +
Blood pressure <140/90 +
Tobacco non-use +
Aspirin use +
59 2014 Pope Mixed USA PGPD Not reported Global payment + shared savings To Beneficiaries assigned to PGPs 1,776,387 person-years 1,579,080 person-years Medical spending + B1
Hospitalizations +
ED visits +
HbA1C testing +
LDL-C testing +
Medical attention for nephropathy +
Diabetes eye exam +
Left ventricular ejection fraction testing 0
Lipid profile +
Breast cancer screening +
90 2019 Kim QN USA MSSP Not reported Global payment + shared savings To Medicare FFS beneficiaries with a cancer diagnosis who were 66 years or older and died in 2013-2014 9,033 beneficiaries 9,033 beneficiaries ≥1 ICU admission (Aggressive end-of-life care) – B2
≥2 Hospitalizations (Aggressive end-of-life care) +
≥2 ED visits (Aggressive end-of-life care) 0
Chemotherapy ≤2 weeks (Aggressive end-of-life care) 0
No hospice or enrolment ≤3 days (Aggressive end-of-life care) 0
91 2014 Colla QN USA PGPD Not reported Global payment + shared savings To FFS Medicare patients assigned to PGPs 819,779 patients 934,621 patients Discretionary carotid imaging use 0 B1
Discretionary coronary imaging use 0
Discretionary carotid procedures use 0
Discretionary coronary procedures use 0
Non-discretionary carotid procedures use 0
Non-discretionary coronary procedures use 0
60 2019 Rutledge Mixed USA Medicaid ACO Not reported Global payment + P4P + shared savings To ACOs in Maine, Minnesota and Vermont 3 ACOs Not specified Primary care provider visits (Maine, Minnesota, Vermont) –/–/0 B1
Acute inpatient hospitalizations (Maine, Minnesota, Vermont) +/–/+
ED visits (Maine, Minnesota, Vermont) +/+/+
30-day readmissions (Maine, Minnesota, Vermont) 0/+/0
HbA1C testing (Maine, Minnesota) 0/+
Medication adherence for depression (Maine, Minnesota) 0/–
Developmental screening (Vermont) +
Total spending (Maine, Minnesota, Vermont) 0/0/+
Inpatient spending (Maine, Minnesota, Vermont) 0/0/+
Professional spending (Maine, Minnesota, Vermont) 0/+/+
Pharmaceutical spending (Maine, Vermont) 0/+
61 2019 Borza QN USA MSSP Not reported Global payment + shared savings To Patients undergoing common surgical procedures at ACO-affiliated hospitals 80,501 patients 348,774 patients Overall 30-day readmission + B1
Readmission after AAA repair 0
Readmission after colectomy 0
Readmission after cystectomy 0
Readmission after Prostatectomy 0
Readmission after lung resection 0
Readmission after total knee arthroplasty +
Readmission after total hip arthroplasty 0
101 2019 Diana QN USA Pioneer, MSSP Not reported Global payment + shared savings To ACO-affiliated hospitals 615 hospitals 2,847 hospitals Communication with nurses (patient experience) (Pioneer/MSSP) +/0 B2
Communication with doctors (patient experience) (Pioneer/MSSP) +/0
Responsiveness of hospital staff (patient experience) (Pioneer/MSSP) 0/0
Pain management (patient experience) (Pioneer/MSSP) 0/0
Communication about medications (patient experience) (Pioneer/MSSP) 0/0
Cleanliness of hospital environment (patient experience) (Pioneer/MSSP) 0/0
Quietness of hospital environment (patient experience) (Pioneer/MSSP) 0/0
Discharge information (patient experience) (Pioneer/MSSP) 0/0
Overall hospital rating (patient experience) (Pioneer/MSSP) 0/0
Recommend the hospital (patient experience) (Pioneer/MSSP) 0/0
92 2019 Trinh QN USA MSSP Not reported Global payment + shared savings To FFS, non-HMO beneficiaries 51,980 beneficiaries 222,800 beneficiaries Rates of prostate specific antigen screening 0 B1
Rates of prostate biopsy 0
83 2017 Zhang QN USA Pioneer Not reported Global payment + shared savings To FFS Medicare beneficiaries 316,366 beneficiaries 559,241 beneficiaries Medicare Part D drug spending 0 B1
Total prescriptions filled 0
Medicare Part A/B medical spending +
62 2017 Winblad QN USA Pioneer, MSSP Not reported Global payment + shared savings To ACO-affiliated hospitals 226 hospitals 1,844 hospitals 30-day overall adjusted rehospitalization rate (MSSP/Pioneer) +/+ B1
63 2019 Kaufman QN USA MSSP Not reported Global payment + shared savings To MSSP hospitals 273 hospitals 1,490 hospitals Discharge to home – B1
30-day all-cause readmissions 0
Hospital length of stay 0
Days in the community 0
Mortality 0
Recurrent stroke within 1 year of hospitalization 0
64 2019 Bain QN USA MSSP Not reported Global payment + shared savings To MSSP hospitals 233 hospitals 3,100 hospitals Probability of discharge to one-star (low-rated) SNFs 0 B1
Probability of discharge to five-star (high-rated) SNFs +
93 2018 Resnick QN USA MSSP Not reported Global payment + shared savings To Medicare Part A and B beneficiaries > 65 years 4,989,210 beneficiary-years 12,263,135 beneficiary-years Breast cancer screening use – B1
Colorectal cancer screening use +
Prostate cancer screening use +
65 2018 Kim QN USA MSSP Not reported Global payment + shared savings To MSSP hospitals Varied per measure Varied per measure 30-day hospital-wide all cause readmission rates + B1
30-day readmissions rates for AMI 0
30-day readmissions rates for heart failure +
30-day readmissions rates for pneumonia +
77 2019 Cole QN USA MSSP Not reported Global payment + shared savings To Medicare Part A and B beneficiaries ≥ 67 years with prostate cancer 3,297 beneficiaries 24,088 beneficiaries Radical prostatectomy spending 0 B1
Radiation therapy (EBRT, IMRT, Brachytherapy) spending 0
Expectant management (no surgery, radiation treatment within the first 180 days after diagnosis) spending 0
66 2016 Busch QN USA Pioneer, MSSP Not reported Global payment + shared savings To Medicare beneficiaries ≥ 18 years with mental health illness Not specified Not specified All mental health care spending (Pioneer 2012 performance year/Pioneer 2013 performance year/MSSP 2012 entry cohort/MSSP 2013 entry cohort) +/0/0/0 B1
Outpatient mental health care spending (Pioneer 2012 performance year/Pioneer 2013 performance year/MSSP 2012 entry cohort/MSSP 2013 entry cohort) 0/0/0/0
ED visits with mental health diagnosis spending (Pioneer 2012 performance year/Pioneer 2013 performance year/MSSP 2012 entry cohort/MSSP 2013 entry cohort) +/0/0/0
Inpatient admissions with mental health diagnosis spending (Pioneer 2012 performance year/Pioneer 2013 performance year/MSSP 2012 entry cohort/MSSP 2013 entry cohort) +/0/0/0
30-day mental health readmissions (Pioneer 2012 performance year/Pioneer 2013 performance year/MSSP 2012 entry cohort/MSSP 2013 entry cohort) 0/0/0/0
Outpatient mental health follow-up within 7 days of discharge (Pioneer 2012 performance year/Pioneer 2013 performance year/MSSP 2012 entry cohort/MSSP 2013 entry cohort) 0/0/0/0
Identified as having a depressive disorder (Pioneer 2012 performance year/Pioneer 2013 performance year/MSSP 2012 entry cohort/MSSP 2013 entry cohort) 0/0/–/0
67 2015 McWilliams QN USA Pioneer Not reported Global payment + shared savings To Fee-for-service Medicare beneficiaries 768,054 beneficiary-years 19,152,460 beneficiary-years Total spending + B1
30-day readmissions 0
Hospitalizations for ambulatory-care sensitive conditions 0
CHF hospitalizations 0
COPD or asthma hospitalizations 0
Cardiovascular disease or diabetes hospitalizations 0
Screening mammography (for women 65–69 years) 0
HbA1C testing +
LDL-C testing +
Diabetic retinal examination +
68 2016 McWilliams QN USA MSSP Not reported Global payment + shared savings To Fee-for-service Medicare beneficiaries 884,810 (2012 cohort) and 1,015,722 beneficiary-years (2013 cohort) 10,924,440 (2012 cohort) and 14,587,259 beneficiary-years (2013 cohort) Total spending (2012/2013 entry cohort) +/0 B1
30-day readmissions 0
Hospitalizations for ambulatory-care sensitive conditions 0
CHF hospitalizations 0
COPD or asthma hospitalizations (2012/2013 entry cohort) +/0
Cardiovascular disease or diabetes hospitalizations 0
Screening mammography (for women 65–69 years) 0
HbA1C testing 0
LDL-C testing (2012/2013 entry cohort) +/0
Diabetic retinal examination (2012/2013 entry cohort) 0/+
Low-value services provided 0
79 2018 Lam QN USA MSSP Not reported Global payment + shared savings To Medicare FFS beneficiaries ≥ 65 years with cancer 388,784 patients 233,296 patients Lung cancer spending 0 B1
Hematologic cancer spending 0
Gastrointestinal cancer spending 0
Breast cancer spending 0
Genitourinary cancer spending 0
Gynaecologic cancer spending 0
Head and neck cancer spending 0
Sarcoma spending 0
Melanoma spending 0
Central nervous system cancer spending 0
Metastatic disease (primary unknown) spending 0
Total spending 0
Inpatient spending 0
Outpatient cancer spending 0
Physician services spending 0
SNF spending 0
HHA spending 0
Hospice spending 0
Radiation therapy spending 0
Chemotherapy spending 0
69 2018 Duggal QN USA Pioneer, MSSP Not reported Global payment + shared savings To ACO-affiliated hospitals 129 Pioneer-affiliated hospitals and 342 MSSP-affiliated hospitals 3,907 hospitals Heart failure 30-day readmission rate (MSSP/Pioneer) +/0 B1
AMI 30-day readmission rate (MSSP/Pioneer) 0/0
Pneumonia 30-day readmission rate (MSSP/Pioneer) 0/0
81 2018 McWilliams QN USA MSSP Physician-group ACOs (narrow scope of provided services) and hospital-integrated ACOs (wider scope of provided services) Global payment + shared savings To Fee-for-service Medicare beneficiaries Hospital-integrated ACOs (132) and physician-group ACOs (203) Not specified Physician group ACO spending (2012/13/14 entry cohort) +/+/+ B1
Hospital-integrated ACO spending (2012/13/14 entry cohort) +/0/0
94 2019 Modi QN USA MSSP Not reported Global payment + shared savings To Medicare part A and B FFS beneficiaries ≥ 66 years undergoing meniscectomy, vertebroplasty or hip fracture procedure 21,486 meniscectomy, 12,521 vertebroplasty and 13,930 hip fracture patients 54,770 meniscectomy, 32,018 vertebroplasty and 36,830 hip fracture patients Arthroscopic partial meniscectomy (low-value procedure) use 0 B1
Vertebroplasty (low-value procedure) use 0
70 2016 Herrel QN USA MSSP Not reported Global payment + shared savings To Patients aged 66 to 99 years that underwent major cancer surgery for nine solid organ cancers 19,439 patients 365,080 patients 30-day mortality 0 B1
30-day readmissions 0
30-day major complications 0
Hospital length of stay 0
76 2018 Borza QN USA MSSP Not reported Global payment + shared savings To Medicare part A and B FFS beneficiaries ≥ 66 years with prostate cancer 5,065 patients 27,946 patients Treatment rate in highest mortality risk (overtreatment) + B1
Overall payments 0
Payments in highest mortality risk 0
78 2016 Colla QN USA Pioneer, MSSP Not reported Global payment + shared savings To (1) Medicare part A and B FFS beneficiaries and (2) Medicare part A and B FFS beneficiaries ≥ 66 years with multiple clinical conditions (clinically vulnerable) Not specified Not specified Total spending (Pioneer 2012 entry cohort/MSSP 2012 entry cohort/MSSP 2013 entry cohort) +/+/+ B1
Spending among clinically vulnerable beneficiaries (Pioneer 2012 entry cohort/MSSP 2012 entry cohort/MSSP 2013 entry cohort) +/+/+
95 2018 Resnick QN USA MSSP Not reported Global payment + shared savings To Medicare Part A and B beneficiaries > 65 years 13,460,798 person-years 40,010,199 person-years Breast cancer screening use among appropriate candidates + B1
Colorectal cancer screening use among appropriate candidates +
Prostate cancer screening use among appropriate candidates 0
82 2015 Schwartz QN USA Pioneer Not reported Global payment + shared savings To Medicare Part A and B beneficiaries 693,218 person-years 17,453,423 person-years Total low-value services use + B1
Total low-value services spending +
Cancer screening use +
Testing use +
Preoperative services use 0
Imaging use +
Cardiovascular tests and procedures use +
Other invasive procedures use 0
Higher-priced low-value services use 0
Lower-priced low-value services use +
More patient sensitive low-value services use +
Less patient sensitive low-value services use +
80 2017 McWilliams QN USA MSSP Not reported Global payment + shared savings To Medicare Part A and B beneficiaries Not specified Not specified SNF spending (2012/2013/2014 entry cohort) +/+/0 B1
71 2019 Markovitz QN USA MSSP Not reported Global payment + shared savings To Medicare FFS beneficiaries 835,100 beneficiaries Not reported Total spending 0 B1
HbA1C testing (% meeting quality indicator) 0
LDL-C testing (% meeting quality indicator) –
Diabetic retinal examination (% meeting quality indicator) 0
All 3 diabetes measures (% meeting quality indicator) 0
Mammography (% meeting quality indicator) 0
96 2018 Barnett QN USA MSSP Not reported Global payment + shared savings To Medicare FFS Part A and B beneficiaries Not specified Not specified All specialist visits in primary care oriented ACOs (2012/2013/2014 entry cohort) +/0/0 B1
All specialist visits in specialty oriented ACOs (2012/2013/2014 entry cohort) 0/0/0
New specialist visits in primary care oriented ACOs (2012/2013/2014 entry cohort) +/0/+
New specialist visits in specialty oriented ACOs (2012/2013/2014 entry cohort) 0/0/0
97 2017 McWilliams QN USA MSSP Not reported Global payment + shared savings To Medicare FFS Part A, B and D beneficiaries with cardiovascular disease or diabetes Not specified Not specified Statin use (2012/2013/2014 entry cohort) 0/0/0 B1
Statin PDC (2012/2013/2014 entry cohort) 0/0/0
ACE inhibitor/ARB use (2012/2013/2014 entry cohort) 0/0/0
ACE inhibitor/ARB PDC (2012/2013/2014 entry cohort) 0/0/0
β-Blockers use (2012/2013/2014 entry cohort) 0/0/0
β-Blockers PDC (2012/2013/2014 entry cohort) +/0/0
Thiazide diuretics use (2012/2013/2014 entry cohort) 0/+/0
Thiazide diuretics PDC (2012/2013/2014 entry cohort) 0/0/0
Calcium channel blockers use (2012/2013/2014 entry cohort) 0/0/0
Calcium channel blockers PDC (2012/2013/2014 entry cohort) 0/0/0
Metformin use (2012/2013/2014 entry cohort) 0/0/0
Metformin PDC (2012/2013/2014 entry cohort) +/+/0
72 2015 Nyweide QN USA Pioneer Not reported Global payment + shared savings To Medicare FFS beneficiaries 675,712 beneficiaries in 2012 and 806,258 beneficiaries in 2013 13,203,694 beneficiaries in 2012 and 12,134,154 beneficiaries in 2013 Total Medicare spending (2012/2013 performance year) +/+ B1
All inpatient hospital (Part A) spending (2012/2013 performance year) +/+
Physician (Part B) spending (2012/2013 performance year) +/+
Hospital outpatient spending (2012/2013 performance year) +/0
SNF spending (2012/2013 performance year) +/0
Home health spending (2012/2013 performance year) +/0
Hospice spending (2012/2013 performance year) +/0
Durable medical equipment spending (2012/2013 performance year) +/+
Acute care inpatient days (2012/2013 performance year) +/+
Inpatient admissions through ED (2012/2013 performance year) +/+
IRF or LTC facility days (2012/2013 performance year) 0/+
All-cause 30-day readmissions (2012/2013 performance year) 0/0
Post discharge physician visits within 7 days (2012/2013 performance year) +/+
Post discharge physician visits within 14 days (2012/2013 performance year) 0/+
Post discharge physician visits within 30 days (2012/2013 performance year) 0/0
Primary care evaluation and management visits (2012/2013 performance year) +/+
Procedures use (2012/2013 performance year) +/+
Imaging services use (2012/2013 performance year) +/+
Tests use (2012/2013 performance year) +/+
ED visits (2012/2013 performance year) +/+
Observation stays (2012/2013 performance year) 0/–
SNF days (2012/2013 performance year) +/0
Home health visits (2012/2013 performance year) +/0
Hospice days (2012/2013 performance year) +/0
98 2018 Lin QN USA MSSP Not reported Global payment + shared savings To ACO-affiliated rural health clinics (RHCs) 19 RHCs 484 RHCs Risk-adjusted diabetes hospitalization rate 0 B2
73 2013 Colla QN USA PGPD Not reported Global payment + shared savings To Medicare FFS beneficiaries with cancer 123,249 beneficiaries 865,532 beneficiaries Acute care spending + B1
Imaging spending 0
Deaths occurring in hospital 0
84 2019 Lam QN USA MSSP Not specified Global payment + shared savings To ACO cancer decedents 12,248 patients 12,248 patients Total spending 0 B1
Inpatient spending 0
Outpatient spending 0
Physician services spending 0
SNF spending 0
Home health spending 0
Hospice spending 0
Radiation therapy spending 0
Chemotherapy spending 0
≥1 Emergency room visits (180 days/30 days prior to death) 0/0
≥1 Inpatient hospitalizations (180 days/30 days prior to death) –/0
≥1 ICU admission (180 days/30 days prior to death) 0/0
85 2020 Bakre QN USA MSSP Not specified Global payment + shared savings To Medicare fee-for-service beneficiaries on long-term dialysis 26,694 patients 167,817 patients Total spending + B1
99 2021 Modi QN USA MSSP Not specified Global payment + shared savings To ACO hospitals 707 hospitals 1,770 hospitals AAA treatment rate 0 B1
AVR treatment rate 0
Carotid endarterectomy/stent treatment rate 0
Colectomy treatment rate 0
Lung lobectomy treatment rate 0
Prostatectomy treatment rate 0
Proportion of AAA surgery using EVAR 0
Proportion of AVR using TAVR 0
Proportion of carotid surgery using stenting 0
Proportion of colectomy surgery using minimally invasive approach 0
Proportion of lobectomy surgery using minimally invasive approach 0
Proportion of prostatectomy using minimally invasive approach 0
86 2021 Chang QN USA MSSP Not specified Global payment + shared savings To Long-term nursing home Medicare fee-for-service beneficiaries 121,690 patients 121,690 patients Evaluation & management visits 0 B2
Proportion of evaluation & management visits to primary care physicians +
Total admissions +
ACSC admissions +
30-day readmissions 0
Observation stays 0
ED visits +
Total spending 0
87 2021 Erfani QN USA Medicare ACO Not specified Global payment + shared savings To Medicare fee-for-service beneficiaries aged 65 years or older with cancer 517,623 patients 348,909 patients Lung cancer spending 0 B1
Hematologic cancer spending 0
Gastrointestinal cancer spending 0
Breast cancer spending 0
Genitourinary cancer spending 0
Gynaecologic cancer spending 0
Head and neck cancer spending 0
Sarcoma spending 0
Melanoma spending 0
Central nervous system cancer spending 0
Metastatic disease (primary unknown) spending 0
100 2021 Acevedo QN USA MSSP Not specified Global payment + shared savings To Medicare beneficiaries 853,953 patients with disability (D) and 2,917, 299 patients aged 65 years or older3 (65) 1,675,928 and 5,492,387 patients Any outpatient mental health visits (D/65) +/– B1
Any outpatient substance use visits (D/65) +/0
Any inpatient mental health stays (D/65) +/+
Any inpatient substance use stays (D/65) +/0
Number of inpatient mental health visits (D/65) +/+
Number of inpatient substance use visits (D/65) 0/–
Adequate care for patients with depression (D/65) –/–
102 2020 Lee QN USA MSSP Not specified Global payment + shared savings To Vulnerable ACO beneficiaries in physician group panels 1,024,833 patients 2,912,043 patients Proportion of black patients 0 B1
Proportion of patients that are dually enrolled in Medicare and Medicaid 0
Proportion of patients that live in areas with higher poverty rates 0
Proportion of patients that live in areas with higher unemployment rates 0
89 2020 McWilliams QN USA MSSP Not specified Global payment + shared savings To ACOs across different entry cohorts 114 ACOs (2012 entry cohort), 106 (2013), 115 (2014) Not specified Spending (2012 entry cohort) (2013/14/15) 0/+/+ B1
Spending (2013 entry cohort) (2013/14/15) 0/+/+
Spending (2014 entry cohort) (2014/15) 0/0
75 2019 Zhang QN USA Commercial ACO HMO, large independent practice association of physicians and hospital system Global payment + shared savings To Enrolled members of commercial HMO 40,483 patients 20,275 patients Inpatient and outpatient payments (2010/11/12/13/14) –/–/0/0/0
PCP visits (2010/11/12/13/14) 0/0/0/–/–
Specialist visits (2010/11/12/13/14) –/–/–/–/–
ED visits (2010/11/12/13/14) 0/0/–/0/0
Inpatient admissions (2010/11/12/13/14) 0/0/0/0/–
30-day readmissions (2010/11/12/13/14) 0/0/0/0/0
Breast cancer screening (2010/11/12/13/14) 0/0/0/+/+
Cervical cancer screening (2010/11/12/13/14) 0/0/0/+/+
Colorectal cancer screening (2010/11/12/13/14) 0/0/0/+/+
HPV vaccine (2010/11/12/13/14) 0/0/0/0/+
Immunizations (combination 1) (2010/11/12/13/14) +/0/+/0/+
Meningococcal immunizations +/0/+/0/+
Td/Tdap immunizations 0/0/0/0/0
HbA1c testing 0/0/0/0/0
Medical attention for nephropathy 0/0/0/0/+
88 2021 Zhang QN USA Commercial ACO HMO, large independent practice association of physicians and hospital system Global payment + shared savings To Enrolled members of commercial HMO 11,958 patients 20,275 patients Generic drug use (2010/11/12/13/14) 0/0/0/0/0
Generic drug spending (2010/11/12/13/14) 0/+/0/0/0
Brand drug use (2010/11/12/13/14) 0/0/0/0/0
Brand drug spending (2010/11/12/13/14) 0/0/0/0/0
Total prescription drug use (2010/11/12/13/14) 0/0/+/+/0
Total prescription drug spending (2010/11/12/13/14) 0/0/0/0/0
Medication adherence (2010/11/12/13/14) –/–/–/0/0
74 2020 Marrufo QN USA ESRD Seamless Care Organization (ESCO) Dialysis facilities, nephrologists, and other providers Global payment + shared savings To Medicare fee-for-service beneficiaries 73,094 beneficiaries 60,464 beneficiaries Radiation therapy use (180 days/30 days prior to death) 0/0 B1
Chemotherapy use (180 days/30 days prior to death) 0/0
Hospice use (180 days/30 days prior to death) 0/0
ESRD hospitalization complications payment +
Total dialysis payment –
Hospitalizations +
Readmissions 0
ED visits 0
Emergency dialysis 0
Dialysis sessions +
Catheter placement +
Vascular access complications 0