Medicare ACOs With Cardiologists Save More Money Than ACOs That Exclude Them

Medicare accountable care organizations (ACOs) that include cardiologists as part of their physician networks had lower beneficiary costs for cardiovascular disease than ACOs that exclude them without compromising quality, an AHRQ-funded study found. Annual spending for beneficiaries in a Medicare ACO with cardiologist participation was about $200 lower compared with beneficiary spending in ACOs without cardiologists as a result of lower spending for skilled nursing facilities, evaluation and management services and procedural care. AHRQ-funded researchers analyzed Medicare data of approximately 1.6 million patients per year with cardiovascular disease (heart attacks, atrial fibrillation, congestive heart failure and ischemic heart disease). Even though the number of ACOs more than tripled over the study period (from 114 in 2012 to 392 in 2015), the proportion of ACOs with cardiologist participation remained stable (80 percent in 2012 to 83 percent in 2015). Clinical outcomes, as measured by heart failure admission rates, emergency department visit rates and hospital readmission rates, were essentially the same between the two ACO models. In light of the prevalence of cardiovascular disease, the study findings strengthen the evidence for including cardiologists in ACOs, the study said. Access the abstract of the study published in Circulation: Cardiovascular Quality and Outcomes.