ACO Investment Model Produced Savings, But The Majority Of Participants Exited When Faced With Downside Risk.

Medicare's Accountable Care Organization (ACO) Investment Model (AIM) provided up-front funding to forty-one small, rurally located ACOs to encourage their participation in the Medicare Shared Savings Program. We estimate net savings to Medicare of $381.5 million over three years, driven by utilization reductions in inpatient and other institutional care and by the absence of shared risk for potential increases in Medicare spending incurred by participants.

Comparing Traditional and Disposable Negative-Pressure Wound Therapy Use by Medicare Home Health Patients.

Objective: Since 2017, home health agencies (HHAs) have received reimbursement for the provision of negative-pressure wound therapy (NPWT) using disposable, portable devices to eligible Medicare fee-for-service beneficiaries. This study aimed to describe the use of disposable NPWT (dNPWT) versus traditional, durable medical equipment-based NPWT (tNPWT) in the home health setting over time and compare the types of beneficiaries using and associated Medicare payments for NPWT separate from the home health payment bundle.

Methods: Medicare fee-for-service claims were used to identify beneficiaries receiving NPWT from HHAs during home health stays.

An analysis of Medicare accountable care organization expense reports.

Objectives: To understand the investments that Medicare Shared Savings Program accountable care organizations (ACOs) in the ACO Investment Model (AIM) made to participate in the program and the costs that they incurred as a result of their efforts to lower spending and improve quality.

Study Design: We conducted a systematic review and categorization of all available and approved quarterly expenses reported by AIM ACOs.

Methods: We reviewed final approved quarterly expense reports submitted by ACOs detailing how they spent funds in the quarter.

Early Effects of an Accountable Care Organization Model for Underserved Areas.

Background: The Centers for Medicare and Medicaid Services (CMS) developed the Accountable Care Organization (ACO) Investment Model (AIM) to encourage the growth of Medicare Shared Savings Program (MSSP) ACOs in rural and underserved areas. AIM provides financial support to eligible MSSP ACOs by means of prepayment of shared savings. Estimation of the performance of AIM ACOs on measures of spending and utilization in their first performance year would be useful for understanding the viability of ACOs located in these areas.

Screening for T1D risk to reduce DKA is not economically viable.

Background: Children at high risk for developing type 1 diabetes (T1D) can be identified on the basis of human leukocyte antigen (HLA) genotype and the subsequent development of islet cell autoantibodies. Several studies have documented reduced incidence of diabetic ketoacidosis (DKA) in new-onset T1D when high-risk children are identified at an early age. Many have questioned whether general population screening for T1D risk should be standard of practice.