Premium
The one‐year impact of accountable care networks among Washington State employees
Author(s) -
Coe Norma B.,
Ingraham Bailey,
Albertson Elaine,
Zhou Lingmei,
Wood Suzanne,
Grembowski David,
Conrad Douglas
Publication year - 2021
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.13656
Subject(s) - medicine , proxy (statistics) , demography , health care , percentage point , specialty , data collection , gerontology , environmental health , family medicine , emergency medicine , finance , statistics , business , mathematics , sociology , economics , economic growth
Objective To estimate the impact of a new, two‐sided risk model accountable care network (ACN) on Washington State employees and their families. Data Sources/Study Setting Administrative data (January 2013‐December 2016) on Washington State employees. Study Design We compared monthly health care utilization, health care intensity as measured through proxy pricing, and annual HEDIS quality metrics between the five intervention counties to 13 comparison counties, analyzed separately by age categories (ages 0‐5, 6‐18, 19‐26, 18‐64). Data Collection/Extraction Methods We used difference‐in‐difference methods and generalized estimating equations to estimate the effects after 1 year of implementation for adults and children. Principal Findings We estimate a 1‐2 percentage point decrease in outpatient hospital visits due to the introduction of ACNs (adults: −1.8, P < .01; age 0‐5: −1.2, P = .07; age 6‐18: −1.2, P = .06; age 19‐26; −1.2, P < .01). We find changes in primary and specialty care office visits; the direction of impact varies by age. Dependents age 19‐26 were also responsive with inpatient admissions declines (−0.08 percentage points, P = .02). Despite changes in utilization, there was no evidence of changes in intensity of care and mixed results in the quality measures. Conclusions Washington's state employee ACN introduction changed health care utilization patterns in the first year but was not as successful in improving quality.