Pediatric ACO cuts hospital costs for chronically ill kids

Accountable care organizations (ACOs), like R-rated movies and taverns, seem to be mostly havens for adults. But how do ACOs for pediatric patients fare financially?

That question was asked by Children's Hospitals and Clinics of Minnesota, which examined an ACO that the provider had set up specifically to address the treatment of children enrolled in Medicaid who were suffering from chronic conditions. Altogether, researchers examined the records of 28,794 separate patients treated between September 2013 and May 2015.

Their study, published in JAMA Pediatrics, resulted in a more than 40 percent decrease in inpatient days over the two-year study period. However, there was also a 23.3 percent increase in visits to physician offices, a 5.8 percent increase in emergency room visits, and a 15.3 percent increase in the use of prescription drugs.

But overall, hospital costs decreased for this population by a total of 15.7 percent.

Pediatric providers often collaborate on issues such as patient safety and the avoidance of hospital-acquired infections, as was the case with a group of children's hospitals in Ohio. But there has been scant attention paid to pediatric patients being treated in ACOs. Moreover, only in 2015 was a standardized tool developed to capture patient satisfaction data as it relates to children's hospitals and other pediatric facilities.

Only one other ACO devoted to pediatric patients, Partners for Kids, has published any recent data correlating its services with lower costs.

"Our findings suggest significant and durable inpatient healthcare resource use and cost reductions associated with longer attribution to the ACO, where attribution is a proxy for exposure to consistent primary care within the ACO," the authors wrote.

To learn more:
- read the JAMA Pediatrics abstract