TY - JOUR
AU - M. Kerrissey
AU - S. Jamakandi
AU - M. Alcusky
AU - J. Himmelstein
AU - M. Rosenthal
A1 - 
AB - Amid enthusiasm about accountable care organizations (ACOs) in Medicaid, little is known about the primary care practices engaging in them. We leverage a survey of administrators within a random sample (stratified by ACO) of 225 practices joining Massachusetts Medicaid ACOs (64% response rate; 225 responses). We measure the integration of processes with distinct entities: consulting clinicians, eye specialists for diabetes care, mental/behavioral care providers, and long-term and social services agencies. Using multivariable regression, we examine organizational correlates of integration and assess integration's relationships with care quality improvement, health equity, and satisfaction with the ACO. Integration varied across practices. Clinical integration was positively associated with perceived care quality improvement; social service integration was positively associated with addressing equity; and mental/behavioral and long-term service integration were positively associated with ACO satisfaction (all p < .05). Understanding differences in integration at the practice level is vital for sharpening policy, setting expectations, and supporting improvement in Medicaid ACOs.
AD - Harvard T.H. Chan School of Public Health, Boston, MA, USA.;Johns Hopkins University, Baltimore, MD, USA.;University of Massachusetts Chan Medical School, Worcester, USA.
AN - 37232171
BT - Med Care Res Rev
C5 - Financing & Sustainability; Education & Workforce
CP - 5
DA - Oct
DO - 10.1177/10775587231173474
DP - NLM
ET - 20230526
IS - 5
JF - Med Care Res Rev
LA - eng
N2 - Amid enthusiasm about accountable care organizations (ACOs) in Medicaid, little is known about the primary care practices engaging in them. We leverage a survey of administrators within a random sample (stratified by ACO) of 225 practices joining Massachusetts Medicaid ACOs (64% response rate; 225 responses). We measure the integration of processes with distinct entities: consulting clinicians, eye specialists for diabetes care, mental/behavioral care providers, and long-term and social services agencies. Using multivariable regression, we examine organizational correlates of integration and assess integration's relationships with care quality improvement, health equity, and satisfaction with the ACO. Integration varied across practices. Clinical integration was positively associated with perceived care quality improvement; social service integration was positively associated with addressing equity; and mental/behavioral and long-term service integration were positively associated with ACO satisfaction (all p < .05). Understanding differences in integration at the practice level is vital for sharpening policy, setting expectations, and supporting improvement in Medicaid ACOs.
PY - 2023
SN - 1077-5587
SP - 519
EP - 529+
ST - Integration on the Frontlines of Medicaid Accountable Care Organizations and Associations With Perceived Care Quality, Health Equity, and Satisfaction
T1 - Integration on the Frontlines of Medicaid Accountable Care Organizations and Associations With Perceived Care Quality, Health Equity, and Satisfaction
T2 - Med Care Res Rev
TI - Integration on the Frontlines of Medicaid Accountable Care Organizations and Associations With Perceived Care Quality, Health Equity, and Satisfaction
U1 - Financing & Sustainability; Education & Workforce
U3 - 10.1177/10775587231173474
VL - 80
VO - 1077-5587
Y1 - 2023
ER -