title: ACO-Affiliated Hospitals Reduced Rehospitalizations From Skilled Nursing Facilities Faster Than Other Hospitals.
abstract: Medicare's more than 420 accountable care organizations (ACOs) provide care for a considerable percentage of the elderly in the United States. One goal of ACOs is to improve care coordination and thereby decrease rates of rehospitalization. We examined whether ACO-affiliated hospitals were more effective than other hospitals in reducing rehospitalizations from skilled nursing facilities. We found a general reduction in rehospitalizations from 2007 to 2013, which suggests that all hospitals made efforts to reduce rehospitalizations. The ACO-affiliated hospitals, however, were able to reduce rehospitalizations more quickly than other hospitals. The reductions suggest that ACO-affiliated hospitals are either discharging to the nursing facilities more effectively compared to other hospitals or targeting at-risk patients better, or enhancing information sharing and communication between hospitals and skilled nursing facilities. Policy makers expect that reducing readmissions to hospitals will generate major savings and improve the quality of life for the frail elderly. However, further work is needed to investigate the precise mechanisms that underlie the reduction of readmissions among ACO-affiliated hospitals.
authors.affiliation: Ulrika Winblad (Ulrika.winblad@pubcare.uu.se) was a Harkness Fellow in 2014-15 at the Center for Gerontology and Healthcare Research at the Brown University School of Public Health, in Providence, Rhode Island. She is an associate professor in the Department of Public Health and Caring Sciences at Uppsala University, in Sweden.
authors.forename: Ulrika
authors.initials: U
authors.lastname: Winblad
authors.affiliation: Vincent Mor is a professor at the Center for Gerontology and Healthcare Research, Brown University School of Public Health, and a health scientist at the Providence Veterans Affairs Medical Center.
authors.forename: Vincent
authors.initials: V
authors.lastname: Mor
authors.affiliation: John P. McHugh is an assistant professor in the Department of Health Policy and Management, Mailman School of Public Health, Columbia University, in New York City.
authors.forename: John P
authors.initials: JP
authors.lastname: McHugh
authors.affiliation: Momotazur Rahman is an assistant professor in the Department of Health Services Policy and Practice, Brown University School of Public Health.
authors.forename: Momotazur
authors.initials: M
authors.lastname: Rahman
mesh_terms: D060866:Accountable Care Organizations / Q000706:statistics & numerical data*; D000369:Aged, 80 and over; D005260:Female; D017048:Health Care Costs; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012866:Skilled Nursing Facilities / Q000706:statistics & numerical data*; D014481:United States
keywords: Accountable Care Organizations; Long-Term Care; Medicare; Readmissions; Skilled Nursing Facilities