title: Hospital participation in ACOs associated with other value-based program improvement.
abstract: This paper analyzes whether hospital participation in an accountable care organization (ACO) impacts a hospital's quality improvement and cost reduction outcomes in other value-based purchasing (VBP) programs, including the Hospital Value-Based Purchasing Program (HVBP), the Hospital Readmissions Reduction Program (HRRP), and the Hospital-Acquired Conditions (HAC) Reduction Program.
  
  
  
  Using VBP performance data and Leavitt Partners' ACO data, 2 analyses were performed: 1) a descriptive comparison of VBP performance of hospital ACOs compared with non-ACO hospitals, and 2) a longitudinal analysis of hospitals that became part of an ACO during the second year of performance data.
  
  
  
  In the descriptive analysis, we compared VBP scores for hospital ACOs with non-ACO hospitals. To estimate the effect that becoming an ACO had on a hospital, we evaluated the performance of hospitals that became part of an ACO to all hospitals that never became part of an ACO.
  
  
  
  For fiscal year 2016, hospital ACOs performed better than non-ACO hospitals for the HRRP, but not on the HVBP and the HAC Reduction Programs. Longitudinal analysis, however, reveals that results are varied, with evidence that hospitals joining ACOs did increasingly better than their peers for the HRRP, but had inconsistent results year-over-year with the HVBP.
  
  
  
  Despite similar goals, hospital participation in an ACO is not correlated with improved performance in all Medicare VBP programs. Organizations pursuing accountable care and also attempting to maximize Medicare VBP program performance must recognize the differences in program objectives and create strategies unique to each.
authors.affiliation: Leavitt Partners, 299 South Main St, Ste 2300, Salt Lake City, UT 84112. E-mail: david.muhlestein@leavittpartners.com.
authors.forename: David
authors.initials: D
authors.lastname: Muhlestein
authors.forename: Tianna
authors.initials: T
authors.lastname: Tu
authors.forename: Katelyn
authors.initials: K
authors.lastname: de Lisle
authors.forename: Thomas
authors.initials: T
authors.lastname: Merrill
mesh_terms: D060866:Accountable Care Organizations; D003363:Cost Control; D006302:Health Services Research; D006761:Hospitals; D006801:Humans; D008137:Longitudinal Studies; D006278:Medicare; D009937:Organizational Objectives; D058996:Quality Improvement; D014481:United States; D062505:Value-Based Purchasing