Accountable Care Organizations and Health Disparities of Rural Latinos: A Longitudinal Analysis.

The purpose of this study was 2-fold: (1) to analyze the change in diabetes-related hospitalization rates of rural Latino older adult patients as compared with their White counterparts and (2) to determine what factors, including rural health clinic (RHC) participation in accountable care organizations (ACOs), are related to reduced disparities in diabetes-related hospitalization rates. Data for Latino Medicare beneficiaries who were served by RHCs over an 8-year period were analyzed. First, a difference-of-means test was conducted to determine whether there was a change in disparity from the pre-ACO period (2008-2011) to the post-ACO period (2012-2015).

Trends in Health Disparities of Rural Latinos Pre- and Post-Accountable Care Organization Implementation.

Purpose: We present findings from a longitudinal investigation, the purpose of which was to compare health disparities of rural Latino older adult patients diagnosed with diabetes to their non-Latino White counterparts.

Methodology/approach: A pre-post design was implemented treating Medicare Accountable Care Organization (ACO) participation by Rural Health Clinics (RHCs) as an intervention, and using diabetes-related hospitalizations to measure disparities. Data for a nationwide panel of 2,683 RHCs were analyzed for a study period of eight years: 2008 - 2015.

Impact of Nurse Practitioner Practice Regulations on Rural Population Health Outcomes.

For decades, U.S. rural areas have experienced shortages of primary care providers.

Cost of Practice Transformation in Primary Care: Joining an Accountable Care Organization.

The purpose of this study is to examine the costs related to practice transformation from the perspective of primary care organizations transitioning to become participants in Accountable Care Organizations (ACOs). We pose two research questions: 1) Will a Rural Health Clinic that participates in an Accountable Care Organization see higher or lower cost per visit, and 2) If the cost per visit is higher or lower, how large will that difference be? We analyze administrative data from a panel of over 800 Rural Health Clinics for the period 2007 - 2013 using a treatment effects approach, where a clinic's participation in an ACO is viewed as a "treatment." Since the first year that an RHC could join an ACO was 2012 and our most recent year of complete data is 2013, we restricted our analysis of the impact of participation in an ACO to include only 2012 and 2013 data.

Costs of accountable care organization participation for primary care providers: early stage results.

Background: Little is known about the impact of joining an Accountable Care Organization (ACO) on primary care provider organization's costs. The purpose of this study was to determine whether joining an ACO is associated with an increase in a Rural Health Clinic's (RHC's) cost per visit.

Methods: The analyses focused on cost per visit in 2012 and 2013 for RHCs that joined an ACO in 2012 and cost per visit in 2013 for RHCs that joined an ACO in 2013.

Predictors of Gaps in Patient Safety and Quality in U.S. Hospitals.

Objective: To explore predictors of gaps between observed and best possible Hospital Compare scores in U.S. hospitals.

Participation of Rural Health Care Providers in Accountable Care Organizations: Early Indications.

Recently, some rural health clinics (RHCs) throughout the country have chosen to join groups of health care providers in accountable care organizations (ACOs). Examined are characteristics of Southeastern RHCs and the counties they serve; it is shown how those characteristics compare with other regions across the country and suggested what role those differences might play in an RHC's decision to participate in an ACO. Rural health clinic-related data were collected and summarized for 2 time periods: 2007 and 2011: for 2007, data from RHCs throughout the United States; for 2011, summarized demographic data related to region 4 RHCs specifically.

A method for understanding some consequences of bringing patient-generated data into health care delivery.

Objective: The consequences of personal health record (PHR) phenomena on the health care system are poorly understood. This research measures one aspect of the phenomena--the time-cost impact of patient-generated data (PGD) using discrete event model (DEM) simulation.

Background/significance: Little has been written about the temporal and cognitive burden associated with new workflows that include PGD.

Performance of health centers in networks.

This study analyzed financial and non-financial performance of a national sample of ninety-six community health centers participating in networks funded through the DHHS' Integrated Services Development Initiative.