OBJECTIVES: The accountable care organization (ACO) is a new care coordination model and reimbursement mechanism that incentivizes providers to deliver high-quality and well-coordinated care. Our objective was to determine if ACOs- are associated with lower rates of preventable hospitalizations for persons with Alzheimer’s Disease and if ACOs reduce racial disparities in preventable hospitalizations.

METHODS: We used 2015 Healthcare Cost and Utilization Project inpatient claims data from 11 states and the annual survey of the American Hospital Association. Logistic regression and the Blinder-Oaxaca decomposition method were used.

RESULTS : ACO-affiliated hospitals had on average 14% lower rates of preventable hospitalizations ACO-affiliated (OR=0.86, 95%CI [0.6, 0.98], p=0.02). ACO affiliation explained 3.01% (p<0.01) of the disparity in preventable hospitalizations between Whites and African Americans.

CONCLUSIONS: Policymakers should create incentives for minority-serving providers to participate in ACOs and provide minority-serving ACOs with structural assistance to ensure that they can successfully attain their performance goals.