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Rural Health
Resources by Topic: Accountable Care Organizations

Evaluation of the Accountable Care Organization Investment Model: AIM Impacts in the First Performance Year
Evaluation examining the first year performance of the 47 Accountable Care Organizations (ACOs) participating in the ACO Investment Model (AIM), which tests the use of prepaid shared savings to encourage new ACOs to form in rural and underserved areas (Test 1) and to encourage current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk (Test 2). Describes provider characteristics, beneficiary characteristics, and impacts of the 41 Test 1 AIM ACOs. Includes data on rurality for both Test 1 and Test 2 AIM ACOs.
Additional links: Appendices, Findings At-A-Glance
Date: 08/2018
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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First Annual Report: Next Generation Accountable Care Organization (NGACO) Model Evaluation
Reports initial descriptive and analytic findings for the 18 Next Generation ACOs (NGACOs) that launched in 2016. Includes information on NGACO organizational characteristics, market characteristics, model implementation, and performance. Offers some data and discussion related to the inclusion of rural areas. Also provides information on institutional providers by type of facility, including Critical Access Hospitals, Rural Health Clinics, and Federally Qualified Health Centers.
Additional links: Findings at a Glance, Volume II: Technical Appendices, January 2018
Date: 08/2018
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Does Patient-Centered Medical Home Recognition Relate to Accountable Care Organization Participation?
Examines factors influencing Rural Health Clinic (RHC) participation in the Medicare Shared Savings Program Accountable Care Organizations (MSSP ACOs) based on a survey of all RHCs in 9 states. Offers recommendations for increasing ACO model adoption in rural areas.
Author(s): Yi-Ling Lin, Yuan Du, Cristina Gomez, Judith Ortiz
Citation: Population Health Management, 21(3), 188-195
Date: 06/2018
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2018
Evaluates Medicare payment issues and offers recommendations to the U.S. Congress. Includes a chapter on ensuring appropriate access to and use of hospital emergency department (ED) services that provides extensive information on rural access to ED services and identifies examples of rural off-campus emergency departments. Other sections of the report addressing rural concerns focus on post-acute care, quality and value payment programs, and medical device payment policies. Also includes a report on the effects of the Hospital Readmissions Reduction Program.
Additional links: Fact Sheet
Date: 06/2018
Sponsoring organization: Medicare Payment Advisory Commission
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The Evolution of Annual Wellness Visits at Bellin Health Partners Next Generation Accountable Care Organization
Features a primarily rural Accountable Care Organization serving Michigan's upper peninsula and northeastern Wisconsin. Outlines their initiative to maximize the benefits of annual wellness visits using a care team and health information technology. Addresses provider incentives and efforts to improve care team communications, as well as the initiative's results and next steps.
Date: 05/2018
Sponsoring organization: Centers for Medicare and Medicaid Services
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Relationships and Partnerships: How ACOs Are Improving Treatments for Super-Utilizers
Highlights three rural Accountable Care Organizations (ACOs) that are working to improve care for their super-utilizer patients. Features three success stories showing how the ACOs helped meet patient needs and improve patient health.
Author(s): Allee Mead
Citation: Rural Monitor
Date: 05/2018
Sponsoring organization: Rural Health Information Hub
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Illinois Rural Community Care Organization – Princeton, IL: Statewide Rural Accountable Care Organization
Provides an overview of the work and impact of the Illinois Rural Community Care Organization (IRCCO), a Medicare shared savings Accountable Care Organization (ACO). IRCCO includes 24 Critical Access Hospitals and rural hospitals and associated physician practices and clinics.
Date: 03/2018
Sponsoring organization: American Hospital Association
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ACOs' Impact on Hospitalization Rates of Rural Older Adults with Diabetes: Early Indications
Examines the impact of Accountable Care Organizations (ACOs) on reducing the hospitalization rate for diabetes related conditions of older adults living in rural southeast areas of the U.S. where the prevalence of diagnosed diabetes is higher. Highlights the characteristics of Rural Health Clinics (RHCs) participating in ACOs and the adult patients they serve.
Author(s): Yi-Ling Lin, Judith Ortiz, Celeste Boor
Citation: Family & Community Health, 41(4), 265-273
Date: 2018
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Cost of Practice Transformation in Primary Care: Joining an Accountable Care Organization
Examines the cost of becoming part of an Accountable Care Organization (ACO) for Rural Health Clinics (RHCs) using data from over 800 RHCs in nine states. Compares the cost per patient of RHCs that were part of the Medicare Shared Savings Program to a similar group of RHCs that were not part of the program.
Author(s): Richard Hofler, Judith Ortiz, Brian Cote
Citation: Journal of Health Care Finance, 44(3), 1-16
Date: 2018
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Emerging Strategies to Ensure Access to Health Care Services: Frontier Health System
Discusses the challenges of providing care in frontier communities and offers solutions for improving access to and delivery of care. Proposes the creation of a frontier-specific accountable care organization (ACO), the Frontier Health System (FHS), that provides traditional ACO services along with transportation, swing beds, home-based care, expanded visiting nurse services, and more.
Date: 11/2017
Sponsoring organization: American Hospital Association
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