TY - JOUR
KW - Cost of Health Care
KW - Medicare, Mental Health/Substance Abuse
KW - Organization and Delivery of Care
KW - Quality of Care
AU - A. B. Busch
AU - H. A. Huskamp
AU - J. M. McWilliams
A1 - 
AB - People with mental illness use more health care and have worse outcomes than those without such illnesses. In response to incentives to reduce spending, accountable care organizations (ACOs) may therefore attempt to improve their management of mental illness. We examined changes in mental health spending, utilization, and quality measures associated with ACO contracts in the Medicare Shared Savings Program and Pioneer model for beneficiaries with mental illness, using Medicare claims for the period 2008-13 and difference-in-differences comparisons with local non-ACO providers. Pioneer contracts were associated with lower spending on mental health admissions in the first year of the contract, an effect that was attenuated in the second year. Otherwise, ACO contracts were associated with no changes in mental health spending or readmissions, outpatient follow-up after mental health admissions, rates of depression diagnosis, or mental health status. These results suggest that ACOs have not yet focused on mental illness or have been largely unsuccessful in early efforts to improve their management of it.
BT - Health affairs (Project Hope)
C5 - Financing & Sustainability; Healthcare Disparities
CP - 7
CY - United States
DO - 10.1377/hlthaff.2015.1669
IS - 7
JF - Health affairs (Project Hope)
N2 - People with mental illness use more health care and have worse outcomes than those without such illnesses. In response to incentives to reduce spending, accountable care organizations (ACOs) may therefore attempt to improve their management of mental illness. We examined changes in mental health spending, utilization, and quality measures associated with ACO contracts in the Medicare Shared Savings Program and Pioneer model for beneficiaries with mental illness, using Medicare claims for the period 2008-13 and difference-in-differences comparisons with local non-ACO providers. Pioneer contracts were associated with lower spending on mental health admissions in the first year of the contract, an effect that was attenuated in the second year. Otherwise, ACO contracts were associated with no changes in mental health spending or readmissions, outpatient follow-up after mental health admissions, rates of depression diagnosis, or mental health status. These results suggest that ACOs have not yet focused on mental illness or have been largely unsuccessful in early efforts to improve their management of it.
PP - United States
PY - 2016
SN - 1544-5208; 0278-2715
SP - 1247
EP - 1256
EP - 
T1 - Early Efforts By Medicare Accountable Care Organizations Have Limited Effect On Mental Illness Care And Management
T2 - Health affairs (Project Hope)
TI - Early Efforts By Medicare Accountable Care Organizations Have Limited Effect On Mental Illness Care And Management
U1 - Financing & Sustainability; Healthcare Disparities
U2 - 27385241
U3 - 10.1377/hlthaff.2015.1669
VL - 35
VO - 1544-5208; 0278-2715
Y1 - 2016
ER -