Proving That Value-Based Care Can “Bend the Cost Curve”
A study published in Pediatrics demonstrated the cost-saving and health care quality outcomes of the pediatric accountable care organization (ACO) Partners for Kids®. Results of this study indicate that Partners for Kids successfully improved the value of pediatric health care over time through cost containment, while maintaining quality of care.
Partners for Kids serves more than 400,000 Medicaid-eligible children in Ohio and is designed to address rising costs and concerns about the quality of care delivered to low-income patients. ACOs are responsible for health care costs and quality across a defined population. To succeed, the ACO must improve value by reducing costs while either maintaining or improving the quality and outcomes of care.
The study assessed the value of care provided by Partners For Kids from January 2008 through December 2013. Costs of care were compared to overall reported costs of Medicaid within Ohio. Quality measures were derived from the Agency for Healthcare Research and Quality (AHRQ) Pediatric Quality Indicators, which focus on potentially preventable complications and hospitalizations and provide targets for interventions at both the provider and patient level. Four additional measures targeted specifically by Partners For Kids included neonatal intensive care days; emergency department visits due to asthma; diabetes care management; and 3- to 6-year-old well-child checks.
Results of cost comparisons indicated that Partners For Kids had lower cost growth than Medicaid fee-for-service programs and Medicaid managed care plans. From 2008 to 2013, costs per member per month for Partners For Kids grew at a rate of $2.40 per year. Managed care plans grew at a rate of $6.47 per year and Medicaid fee-for-service costs grew at a rate of $16.15 per year.
Quality metrics based on AHRQ indicators stayed consistent on most other measures, showed improvement for three measures (including two measures of overall quality of care), and declined on two measures. Partners For Kids-specific quality measures showed improvements including fewer NICU days, fewer visits to the ED for asthma and a significant increase in the number of well-child visits. A slight deterioration was seen in diabetes care management.
Overall, the results indicate the Partners For Kids model substantially reduced growth in the cost of care compared to other Ohio Medicaid plans. In addition, quality-of-care measures held steady, with some small changes in both directions.
“Partners For Kids delivered on the promise of the ACO to reduce the rate of health care cost growth while maintaining or improving the quality of care,” Dr. Kelleher states.