For a study, researchers sought to assess the relationship between post-acute care (PAC) utilization and cost in Medicare accountable care organizations (ACOs), hospital involvement, and post-surgical outcomes in Medicare beneficiaries having urologic cancer procedures. The use of accountable care organizations (ACOs) in urologic cancer treatment has not been well studied, despite recent Medicare payment innovations, including accountable care organizations and rising rates of urologic cancer and surgical care accounting for a significant percentage of overall health care expenses.

To evaluate post-surgical outcomes between Medicare ACO and non-ACO patients before and after adopting the Medicare shared savings program (MSSP), they performed a longitudinal study of 2011-2017 Medicare claims data. The outcomes of interest were post-acute care (PAC) utilization (general, institutional, and home health), duration of stay in skilled nursing facilities (SNF), Medicare spending for SNF patients, unplanned readmissions at 30 and 90 days after the index surgery, and complications.

A total of 334,514 Medicare patients who underwent surgery for kidney, bladder, or prostate cancer at 2,066 non-ACO hospitals and 524 Medicare ACO hospitals made up the study sample. Participation in a Medicare ACO was linked to considerably lower total post-acute care utilization for bladder cancer surgery but not changes in readmission or complication rates. They found no evidence of a connection between hospital participation in Medicare ACOs and PAC usage or post-surgical outcomes for prostate cancer or kidney cancer surgery.

Participation in MSSP ACOs by hospitals reduces the need for post-acute care without affecting patient outcomes for Medicare beneficiaries having surgery for bladder cancer. Future studies were required to comprehend the longer-term effects of ACO membership on the results of urologic cancer surgery.

 

Reference: goldjournal.net/article/S0090-4295(22)00525-8/fulltext