title: Quality Improvement Strategies in Accountable Care Organization Hospitals.
abstract: BACKGROUND
  Accountable Care Organizations (ACOs) are hoped to lower costs and improve health care quality. However, hospitals remain unsure how to bring about the quality improvement (QI) required to increase financial viability. This success may hinge on the use of sophisticated measurement tracking and the use of multiple QI tools. This study aims to assess the current approaches that ACO hospitals are using to improve quality and to compare their strategies with non-ACO hospitals.
  
  
  METHODS
  The 2013 American Hospital Association's Annual Survey and the Survey of Care Systems and Payment data were merged to identify ACO and non-ACO hospitals. ACO and non-ACO hospital rates of reported use of multiple QI tools and the ability to detect and track readmissions across organizational boundaries were compared.
  
  
  RESULTS
  ACO hospitals were significantly less likely to use only 1 QI tool (43.5% vs 65.2%; P < .001) and more likely to use 2 (36.4% vs 28.1%; P < .05), 3 (12.1% vs 6.5%; P < .001), or 4 (8.0% vs 0.2%; P < .001) QI tools. ACO hospitals were significantly more likely to have the capability to detect readmissions (34.1% vs 22.8%; P < .001) and track readmissions (90.5% vs 85.7%; P < .05).
  
  
  CONCLUSIONS
  Results suggest that ACO hospitals are incorporating more sophisticated measurements and combinations of QI tools than non-ACO hospitals. It remains to be seen whether this leads to accelerated changes across the quality domains in ACO hospitals.
authors.affiliation: Global Health Management and Policy, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana (Dr Mora); and Department of Family Medicine, The Ohio State University Wexner Medical Center, Columbus (Dr Walker).
authors.forename: Arthur M
authors.initials: AM
authors.lastname: Mora
authors.forename: Daniel
authors.initials: D
authors.lastname: Walker
mesh_terms: D060866:Accountable Care Organizations / Q000458:organization & administration* / Q000592:standards; D006739:Hospital Administration; D006742:Hospital Bed Capacity; D006801:Humans; D010067:Ownership; D010359:Patient Readmission; D058996:Quality Improvement / Q000458:organization & administration*; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care / Q000458:organization & administration; D012111:Residence Characteristics; D014481:United States