- Book学术

发布求助

文献互助智能选刊最新文献

IF 13 1区医学 Q1 CLINICAL NEUROLOGY

Alzheimer's & Dementia Pub Date : 2025-03-29 DOI:10.1002/alz.70067

Seyeon Jang, Jie Chen

{"title":"Accountable care organizations and Medicare payments for residents with ADRD in disadvantaged neighborhoods","authors":"Seyeon Jang, Jie Chen","doi":"10.1002/alz.70067","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> INTRODUCTION</h3>\n \n <p>Accountable care organizations (ACOs) are well positioned to promote care coordination. However, robust evidence of ACOs’ impact on Medicare payments for residents with Alzheimer's disease and related dementias (ADRD) in disadvantaged neighborhoods remains limited.</p>\n </section>\n \n <section>\n \n <h3> METHODS</h3>\n \n <p>Using a 2016 to 2020 longitudinal dataset, we examined the effects of ACO enrollment on Medicare payments for people newly diagnosed with ADRD, focusing on the neighborhood Social Vulnerability Index (SVI) and its subcategories. Multivariable generalized estimating equation (GEE) models were applied.</p>\n </section>\n \n <section>\n \n <h3> RESULTS</h3>\n \n <p>ACO enrollment was associated with significantly reduced total payments across all SVI subcategories. The highest cost savings were observed among ADRD patients living in neighborhoods with high proportions of racial and ethnic minorities. Results also showed that higher quality ACOs were associated with lower total payments.</p>\n </section>\n \n <section>\n \n <h3> DISCUSSION</h3>\n \n <p>ACOs have a great potential to save health-care costs for beneficiaries with ADRD living in socially vulnerable neighborhoods, particularly for those residing in areas with higher proportions of racial and ethnic minority populations.</p>\n </section>\n \n <section>\n \n <h3> Highlights</h3>\n \n <div>\n <ul>\n \n <li>Accountable care organizations (ACOs) reduced Medicare payments for Alzheimer's disease and related dementias across neighborhood disadvantage levels.</li>\n \n <li>The cost reductions varied by specific indicators of social vulnerability.</li>\n \n <li>Highest cost savings were found among residents living with high proportion of racial/ethnic minorities.</li>\n \n <li>Cost savings were the greatest among the highest quality ACOs.</li>\n </ul>\n </div>\n </section>\n </div>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"21 3","pages":""},"PeriodicalIF":13.0000,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alz.70067","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Alzheimer's & Dementia","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/alz.70067","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

摘要

引言责任医疗组织 (ACO) 具有促进护理协调的优势。然而，关于 ACO 对贫困社区阿尔茨海默病及相关痴呆症（ADRD）患者的医疗保险支付影响的有力证据仍然有限。方法我们使用 2016 年至 2020 年的纵向数据集，研究了 ACO 注册对新诊断为 ADRD 患者的医疗保险支付的影响，重点关注邻里社会弱势指数（SVI）及其子类别。应用了多变量广义估计方程 (GEE) 模型。结果在所有 SVI 子类别中，ACO 的加入与总支出的大幅减少有关。居住在少数种族和少数民族比例较高社区的 ADRD 患者节省的费用最高。结果还显示，质量较高的 ACO 与较低的总费用相关。讨论对于居住在社会弱势社区的 ADRD 患者，尤其是居住在少数民族人口比例较高地区的 ADRD 患者而言，ACO 在节约医疗成本方面具有巨大潜力。亮点责任医疗组织（ACOs）减少了医疗保险对阿尔茨海默氏症及相关痴呆症的支付，降低了各社区的不利程度。不同的社会脆弱性指标所降低的费用也不同。少数种族/族裔比例高的居民节省的费用最高。在质量最高的 ACO 中，成本节约幅度最大。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Accountable care organizations and Medicare payments for residents with ADRD in disadvantaged neighborhoods

查看原文本刊更多论文

Accountable care organizations and Medicare payments for residents with ADRD in disadvantaged neighborhoods

INTRODUCTION

Accountable care organizations (ACOs) are well positioned to promote care coordination. However, robust evidence of ACOs’ impact on Medicare payments for residents with Alzheimer's disease and related dementias (ADRD) in disadvantaged neighborhoods remains limited.

METHODS

Using a 2016 to 2020 longitudinal dataset, we examined the effects of ACO enrollment on Medicare payments for people newly diagnosed with ADRD, focusing on the neighborhood Social Vulnerability Index (SVI) and its subcategories. Multivariable generalized estimating equation (GEE) models were applied.

RESULTS

ACO enrollment was associated with significantly reduced total payments across all SVI subcategories. The highest cost savings were observed among ADRD patients living in neighborhoods with high proportions of racial and ethnic minorities. Results also showed that higher quality ACOs were associated with lower total payments.

DISCUSSION

ACOs have a great potential to save health-care costs for beneficiaries with ADRD living in socially vulnerable neighborhoods, particularly for those residing in areas with higher proportions of racial and ethnic minority populations.

Highlights

Accountable care organizations (ACOs) reduced Medicare payments for Alzheimer's disease and related dementias across neighborhood disadvantage levels.
The cost reductions varied by specific indicators of social vulnerability.
Highest cost savings were found among residents living with high proportion of racial/ethnic minorities.
Cost savings were the greatest among the highest quality ACOs.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Alzheimer's & Dementia 医学-临床神经学

CiteScore

14.50

自引率

5.00%

发文量

299

审稿时长

3 months

期刊介绍： Alzheimer's & Dementia is a peer-reviewed journal that aims to bridge knowledge gaps in dementia research by covering the entire spectrum, from basic science to clinical trials to social and behavioral investigations. It provides a platform for rapid communication of new findings and ideas, optimal translation of research into practical applications, increasing knowledge across diverse disciplines for early detection, diagnosis, and intervention, and identifying promising new research directions. In July 2008, Alzheimer's & Dementia was accepted for indexing by MEDLINE, recognizing its scientific merit and contribution to Alzheimer's research.