Research

At the Institute for Accountable Care our work is focused on assessing the impact of accountable care practices using state-of-the-art research methods. Our senior staff have appointments at Brandeis University and stay current with the latest techniques in healthcare data analysis. We also have expertise in qualitative methods, and we use mixed-methods research to ensure that what we see in administrative data is consistent with what is happening in the field. We work closely with accountable care organizations to ensure we are solving real-world problems to advance the Triple Aim of better outcomes, improved health and lower costs. Below are some of our recent projects.

Analysis of Telehealth Utilization During the COVID-19 Pandemic

In partnership with the West Health Institute we are analyzing telehealth utilization in 2020 to assess how effectively different types of provider organizations deployed telehealth services; what types of beneficiaries receive telehealth services; and how patterns of service varied across regions. The analysis usedb a 100% national sample of 2020 monthly claims data and includes interviews with ACO leaders to assess how organizations are rolling out telehealth and what challenges they have encountered. You can download the paper here.

Synopsis of Key Areas in the Recent Academic Literature on Accountable Care

Working with the Council of Accountable Physician Practices the Institute convened a group of leading experts to discuss future priorities for accountable care research. To prepare for the round table the Institute prepared a synopsis of recent literature focusing on multi-specialty group characteristics and performance; organizational structure and characteristics; risk sharing and financial arrangements; care redesign initiatives; ACO financial performance; and Medicare Advantage.

Implementing a Claims-Based Fall Measure for Medicare Beneficiaries

The Institute worked with teams from the University of Michigan and the Altarum Institute to implement a claims-based algorithm for identifying and measuring the cost of falls. This measure is being used to monitor the impact of public health interventions to reduce falls among elders across eight communities with wide variations in fall rates. Using our comprehensive, longitudinal Medicare claims data set we have created national snapshots of fall rates across the country to help ACOs, provider and policy makers identify falls “hot spots” and track the impact of fall reduction initiatives.

Economic and Clinical Profiling of Home-Based Primary Care Practices

The Institute assisted the American Academy of Home Care Medicine (AAHCM) with developing a national profile of home-based primary care practices that included detailed characteristics of their patient populations, spending profiles and clinical performance indicators.

Evaluating Changes in Spending and Utilization for Beneficiaries Receiving Community Paramedicine Services

The Institute is helping a large ACO evaluate the impact of a community paramedicine initiative designed to improve care for medically and socially complex patients. This study looks at changes in utilization and spending for ACO beneficiaries receiving community paramedic services compared with matched comparison groups of beneficiaries both within and external to the ACO.

Survey of ACO Home-Based and Post-Acute Care Initiatives

The Institute completed a detailed survey of home-based care and post-acute care initiatives in late 2019 with 170 ACO respondents.  ACOs reported a range of programs including primary care, hospital-level acute care, community paramedic, care transition and community health worker programs with services provided at home. Two-thirds of ACOs reported formal home-based initiatives, informal home-based services or active development of new programs. The results have been submitted for publication.

Risk-Contracting in Accountable Care Organizations

As part of the National Association of ACOs 2018 ACO Survey we asked respondents to report whether they had ACO contracts with traditional Medicare, Medicare Advantage, commercial, and Medicaid plans. Within each category ACOs reported participation in: one-sided shared savings, two-sided shared risk, and full-risk capitation contracts. In addition ACOs were asked to report their principal strategies for managing spending and the major challenges they face in managing risk contracts. An analysis of survey results can be found here.

Initiatives to Improve Care for High-Cost, High-Need Patients in Accountable Care Organizations

The Institute is committed to helping ACO improve care for high-need, high-cost patients. We have the ability to analyze spending and health outcomes for specific segments within this population using an algorithm developed at Harvard University. In 2018 the Institute conducted a survey of ACOs to assess the initiatives they have put in place to improve care for medically and socially complex beneficiaries. See a summary of findings.