Impact of Accountable Care Organization (ACO) Enrollment on Health-Related Quality of Life (HRQOL) and Healthcare Costs Among Adult Patients with Cancer
Author(s)
Zhang Y1, Ramachandran S1, Bentley J1, Barnard M1, Bhattacharya K1, Yang Y2
1Department of Pharmacy Administration, University of Mississippi School of Pharmacy, University, MS, USA, 2Department of Pharmacy Administration, University of Mississippi School of Pharmacy, Shanghai, 31, China
OBJECTIVES:
An accountable care organization (ACO) is an alternative payment model to incentivize healthcare practitioners to provide coordinated care to control costs and improve quality. This study aims to evaluate the association between ACO enrollment and health-related quality of life (HRQOL) and healthcare costs among cancer patients.
METHODS:
This is a retrospective analysis of cancer patients using 2015-2016 Medical Expenditure Panel Survey (MEPS) data. ACO enrollment was determined by whether patients received care from an ACO. HRQOL was assessed using the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of the SF-12. All-cause healthcare costs, including medical- and pharmacy-associated costs, adjusted to 2019 US dollars, were calculated. Covariates included patient characteristics identified according to the Andersen Behavioral Model and characteristics of the health organization where patients received care. General linear models were performed to assess the association of ACO with HRQOL. Generalized linear models with log link and gamma distribution were conducted to analyze the impact of ACO enrollment on healthcare costs. MEPS complex sample design was accounted for in all analyses.RESULTS:
We identified 803 cancer patients, which corresponded to an estimated 8,464,501 US residents. The majority were ≥65, female, white, insured, and with multiple chronic conditions. Regression analyses show that patients enrolled in ACOs were more likely to have greater PCS (p < 0.0001) and MCS (p = 0.04) scores. However, ACO enrollment was not found to be significantly associated with healthcare costs (p = 0.515).CONCLUSIONS:
We found no significant association between ACO enrollment and healthcare costs among cancer patients. ACO enrollment was associated with better HRQOL in both domains which might be related to the characteristics of ACOs including strong emphasis on primary care, regular mental health services, and more coordinated care. More research is needed to understand how ACOs impact patients’ HRQOL.Conference/Value in Health Info
Value in Health, Volume 26, Issue 6, S2 (June 2023)
Code
EE515
Topic
Economic Evaluation, Methodological & Statistical Research, Patient-Centered Research, Study Approaches
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes, PRO & Related Methods, Surveys & Expert Panels
Disease
No Additional Disease & Conditions/Specialized Treatment Areas