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Evaluating the effect of medicare shared savings program accountable care organizations on part d pharmaceutical spending and use

He, Meiqi (2017) Evaluating the effect of medicare shared savings program accountable care organizations on part d pharmaceutical spending and use. Master's Thesis, University of Pittsburgh. (Unpublished)

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Abstract

Medicare Shared Savings Program (MSSP) is one major model of the Accountable Care Organizations (ACOs) offered by Medicare to better manage health cost and improve the quality of health services. The payment MSSP ACOs receive from Medicare is directly related to its Medicare Part A and B spending and related health service quality. Currently Medicare Part D spending covering medication cost is not included in the calculation of MSSP ACOs shared savings and risks. Since improvement of medication coverage and drug adherence have been shown to decrease other medical cost such as hospital and outpatient care, ACO providers may be incentivized to increase the shared savings by lowering Part A and B spending through increasing Part D drug prescription. This study evaluated the effect of MSSP ACOs on the Part D spending and utilization with a quasi-natural difference-in-differences model. We investigated the change in outcome variables between pre- and post-ACO enrollment during 2010-2013 by comparing MSSP ACOs and non-ACO Medicare providers.
We found that when individually compared with non-ACO providers, Part D spending and use mildly increased after providers enrolled in MSSP. However, the statistical significance of this effect disappeared after controlling for other ACO providers started their MSSP contracts at different times. To evaluate the c. Characteristics of those providers not considered in this study might also have an influence on Part D spending and thus a valid control group would need to be carefully chosen for future studies.
Public health significance: Understanding the ACO effects on Medicare Part D spending and utilization helps evaluate the success of ACOs to increase shared savings and to improve health quality compared with original management models in Medicare.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
He, Meiqimeh169@pitt.edumeh169
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Thesis AdvisorKrafty, Robertrkrafty@pitt.eduRKRAFTY
Committee MemberYouk, Adaayouk@pitt.eduAYOUK
Committee MemberDriessen, Juliadriessen@pitt.eduDRIESSEN
Date: 29 June 2017
Date Type: Publication
Defense Date: 19 April 2017
Approval Date: 29 June 2017
Submission Date: 3 April 2017
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 37
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Biostatistics
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: Medicare, Accountable Care Organizations, Part D Spending
Date Deposited: 29 Jun 2017 23:11
Last Modified: 01 May 2019 05:15
URI: http://d-scholarship.pitt.edu/id/eprint/31232

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