Social needs, including food, housing, utilities, transportation, and experience with interpersonal violence, are linked to health outcomes. Identifying patients unmet social needs is a necessary first step addressing these yet little known about the prevalence of screening.To characterize screening for by physician practices hospitals.Cross-sectional survey analyses responses hospitals 2017-2018 National Survey Healthcare Organizations Systems. Responses were collected from participants...

<h3>Context</h3>The Centers for Medicare &amp; Medicaid Services (CMS) recently launched accountable care organization (ACO) programs designed to improve quality and slow cost growth. The ACOs resemble an earlier pilot, the Physician Group Practice Demonstration (PGPD), in which participating physician groups received bonus payments if they achieved lower growth than local controls met targets. Although evidence indicates PGPD improved quality, uncertainty remains about its effect on...

The extent to which physicians lead, own, and govern accountable care organizations (ACOs) is unknown. However, physicians' involvement in ACOs will influence how clinicians patients perceive the ACO model, effective these are at improving quality costs, future be organized. From October 2012 May 2013 we fielded National Survey of Accountable Care Organizations, first such survey public private ACOs. We found that 51 percent were physician-led, with another 33 jointly led by hospitals. In 78...

Addressing nonmedical needs—such as the need for housing—is critical to advancing population health, improving quality of care, and lowering costs care. Accountable care organizations (ACOs) are well positioned address these needs. We used qualitative interviews with ACO leaders site visits examine how addressed needs their patients, extent which they did so. developed a typology medical social services integration among ACOs that disentangles service organizational integration. found most...

Accountable care contracts hold physician groups financially responsible for the quality and cost of health delivered to patients. Focusing on clinically vulnerable patients, those with serious conditions who are greatest proportion spending, may result in largest effects both patient outcomes financial rewards participating groups.To estimate effect Medicare accountable organization (ACO) spending high-cost institutional use all beneficiaries beneficiaries.For this cohort study, 2 study...

To develop an exploratory taxonomy of Accountable Care Organizations (ACOs) to describe and understand early ACO development provide a basis for technical assistance future evaluation performance.

Accountable care organizations (ACOs) are a promising payment model aimed at reducing costs while also improving the quality of care. However, there is risk that vulnerable populations may not be fully incorporated into this new model. We define two distinct populations, clinically at-risk and socially disadvantaged, we discuss how ACOs benefit each group. provide framework to use in considering challenges for both patients health systems on path accountable identify policies can help...

Background The Accountable Care Organization ( ACO ) model is rapidly being implemented by Medicare, private payers, and states, but little known about the scope of implementation. Objective To determine number accountable care organizations in United States, where they are located, characteristics associated with formation. Study Design, Methods, Data Cross‐sectional study all s U nited S tates as A ugust 2012. We identified from multiple sources; documented service locations (practices,...

Accountable care organizations (ACOs) may be well positioned to increase the focus on managing behavioral health conditions (mental and substance abuse) through integration of treatment primary care. We used a mixed-methods research design examine extent which ACOs are clinically, organizationally, financially integrating data from 257 respondents National Survey Care Organizations, nationally representative survey ACOs. The were supplemented with semistructured, in-depth interviews clinical...

Relationships between physicians and hospitals have changed considerably over the past decade, as physician groups integrated new public private payment policies created financial interdependence. The extent to which accountable care organizations (ACOs) involve in their operations may prove be vitally important, because managing hospital is a key part of improving health quality lowering cost growth. Using primary data on ACO composition capabilities paired with characteristics, we found...

Accountable care organizations (ACOs) are intended, in part, to improve health quality. However, little is known about how ACOs may affect disparities or providers serving disadvantaged patients perform under Medicare ACO contracts. We analyzed racial and ethnic outcomes among investigate the association between share of an ACO's who members minority groups performance on quality measures. Using data from a national survey ACOs, we found that having higher proportion was associated with...

Despite interest in addressing social determinants of health to improve patient outcomes, little progress has been made integrating services with medical care. We aimed understand how care providers strong motivation (for example, operating under new payment models) and commitment early adopters) fared at patients' needs. collected qualitative data from twenty-two accountable organizations (ACOs). These ACOs were adopters working on initiatives address needs, including such common needs as...

Scholarly and public discourses on Muslim immigrants in Europe have questioned if Islam is an impediment to sociocultural adaptation whether Muslims are a distinctive group their religiosity social values. We use new survey of 480 British conjunction with the Social Attitudes Survey examine differences between non‐Muslim Britons (practice, belief, salience) moral issues regarding gender, abortion, homosexuality. more religious than other Britons, including both Christians “nones.” also...

There are now more than seven hundred accountable care organizations (ACOs) in the United States. This article describes some of their most salient characteristics including number and types contracts involved, organizational structures, scope services offered, management capabilities, development a three-category taxonomy that can be used to target technical assistance efforts examine performance. The current evidence on performance ACOs is reviewed. Since California has largest (N=67)...

Accountable care organizations (ACOs) have incentives to meet quality and cost targets share in any resulting savings. Achieving these goals will require ACOs engage more actively with patients their families. The extent which do so is currently unknown. Using mixed methods, including a national survey, phone interviews, site-visits, we examine the families, explore challenges involved, consider approaches for dealing those challenges. Results indicate that greater ACO use of patient...

Despite the prevalence of vertical integration, data and research focused on identifying describing health systems are sparse. Until recently, we lacked an enumeration understanding how vary by key structural attributes. To fill this gap, Agency for Healthcare Research Quality developed Compendium U.S. Health Systems, a resource to support comparative system performance. In article, describe methods used create present picture integration in United States. We identified 626 2016, which...

A wealth of research on screening for social risks in health care has emerged, but evidence is lacking how risk among physician practices changed over time.

Importance Accountable care organizations (ACOs) under the Medicare Shared Savings Program have long been envisioned as a pathway to improved efficiency and quality of for all beneficiaries. However, little is known about whether changes in health spending associated with ACOs extended beyond ACO-attributed beneficiaries Objective To estimate by non-ACO–attributed after moving geographic areas greater ACO participation. Design, Setting, Participants This repeated cross-sectional study...

Empowering beneficiaries to choose a health plan that meets their needs during the transition Medicaid managed care is critical promote informed decision-making. This study uses North Carolina’s under 1115 waiver examine role of state, plans, and providers in informing about transition. We reviewed policy documents interviewed 43 individuals representing provider practices 10 State Department Health Human Services plans between December 2020 September 2021. Interviewees from state described...

The accountable care organization (ACO) model of health delivery is rapidly being implemented under government and private-sector initiatives. requires that each ACO have a defined patient population for which the will be held both total cost quality performance. However, there no empirical evidence about best way to define how patients are assigned these groups doctors, hospitals, other providers. We examined two major methods defining, or attributing, populations ACOs: prospective method...

Accountable Care Organizations (ACOs) are a delivery and payment model aiming to coordinate care, control costs, improve quality. Medicare ACOs responsible for 8 measures of preventive care quality.To create composite quality examine associations ACO characteristics with performance.This is cross-sectional study Shared Savings Program Pioneer participants. We linked performance descriptive data from the National Survey ACOs. created using exploratory factor analysis, used regression assess...

Accountable care organizations (ACOs) are becoming a common payment and delivery model. Despite widespread interest, little empirical research has examined what efforts or strategies ACOs using to change reduce costs. Knowledge of ACOs' clinical can provide important context for understanding ACO performance, particularly distinguish arenas where have not attempted transformation.The aim the study was understand during first 18 months contracts.We conducted semistructured interviews between...

Policy Points One of the most important possibilities value‐based payment is its potential to spur innovation in upstream prevention, such as attention social needs that lead poor health. Screening patients for risks housing instability and food insecurity represents an early step physician practices can take address needs. At present, adoption risk screening by linked with having high capacity focusing on low‐income populations, but not exposure payment. Expanding may require...