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How does being part of a pediatric accountable care organization impact health service use for children with disabilities?
Health Serv Res. 2019 10;54(5):1007-1015
Authors: Song PH, Xu WY, Chisolm DJ, Alexy ER, Ferrari RM, Hilligoss B, Domino ME
Abstract
OBJECTIVE: To examine the impact of a Medicaid-serving pediatric accountable care organization (ACO) on health service use by children who qualify for Medicaid by virtue of a disability under the “aged, blind, and disabled” (ABD) eligibility criteria.
DATA SOURCES/STUDY SETTING: We evaluated a 2013 Ohio policy change that effectively moved ABD Medicaid children into an ACO model of care using Ohio Medicaid administrative claims data for years 2011-2016.
STUDY DESIGN: We used a difference-in-difference design to examine changes in patterns of health care service use by ABD-enrolled children before and after enrolling in an ACO compared with ABD-enrolled children enrolled in non-ACO managed care plans.
DATA COLLECTION/EXTRACTION METHODS: We identified 17 356 children who resided in 34 of 88 counties as the ACO “intervention” group and 47 026 ABD-enrolled children who resided outside of the ACO region as non-ACO controls.
PRINCIPAL FINDINGS: Being part of the ACO increased adolescent preventative service and decreased use of ADHD medications as compared to similar children in non-ACO capitated managed care plans. Relative home health service use decreased for children in the ACO.
CONCLUSIONS: Our overall results indicate that being part of an ACO may improve quality in certain areas, such as adolescent well-child visits, though there may be room for improvement in other areas considered important by patients and their families such as home health service.
PMID: 31388994 [PubMed – indexed for MEDLINE]
via https://www.ncbi.nlm.nih.gov/pubmed/31388994?dopt=Abstract