Could ACOs Reinforce Disparities Among Patient Populations?
First, the Centers for Medicare & Medicaid Services should mandate the reporting of quality indicators by race and ethnicity within ACOS to determine this impact, both positive and negative, on disparities, they suggest.
Second, they recommend that CMS should examine whether distribution of patients by race and ethnicity between ACOS is associated with quality of care Medicare beneficiaries receive. "Understanding these system level differences is critical for determining program effectiveness and improving its design."
Third, the program should monitor should monitor which clinicians and patients are excluded or choose not to participate. And incentives might ensure adequate representation of diverse patients and healthcare systems.
And fourth, active steps to avoid patient and practice cherry picking may be necessary, although monitoring and enforcing the practice will be challenging.
"ACOS are unlikely to reduce and may even exacerbate disparities in care without active intervention to monitor and incentivize equity within and across ACO populations," they concluded.
Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
- mHealth Tackles Readmissions
- CNO Leads $1M Charge for New Scrubs, Uniforms
- 'Kafkaesque' Value System Unfairly Penalizes Doctor Pay
- Targeting Self-Insured Populations
- MA an Insurance Proving Ground for Providers
- Sharp HealthCare Leaves Pioneer ACO Program
- Some Cancer Hospitals' Quality Data Will Soon Be Public
- Acute Kidney Injury Gets New Focus
- Half of All Primary Care, Internal Medicine Jobs Unfilled in 2013
- Proton Beam Therapy Poised for Growth in US