Open AccessNurse Practitioner Involvement in Medicare Accountable Care Organizations
Author(s) -
Nicole Huang,
Mukaila Raji,
Yu Li Lin,
LinNa Chou,
Yong Fang Kuo
Publication year - 2021
Publication title -
american journal of medical quality
Language(s) - English
Resource type - Journals
eISSN - 1555-824X
pISSN - 1062-8606
DOI - 10.1177/1062860620935199
Subject(s) - medicine , nursing , family medicine , nurse practitioners , health care , law , political science
The objective was to examine trend and care quality outcomes associated with nurse practitioner (NP) involvement in Accountable Care Organizations (ACOs) via a cross-sectional study of 521 Medicare Shared Savings Program ACOs during 2014 to 2016. Data include ACO provider/beneficiary files, Medicare claims, and ACO performance data with a focus on Medicare beneficiaries with diabetes, chronic obstructive pulmonary disease, or heart failure. ACO care quality measures were stratified by NP involvement and adjusted for patient, provider, and ACO factors. NP involvement was highest in larger ACOs, states that allow NPs full scope of practice, and rural areas. Greater involvement was associated with fewer readmissions and higher scores on measures of preventive care but not chronic disease and medication management. Greater NP involvement in ACOs was associated with improvement in some care quality measures. With NPs' increasing involvement in ACOs, more research is needed to understand the NP role in processes and outcomes of care.