ACOs save on backs of SNFs

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Providers taking part in a Medicare experiment saved money by funneling care away from skilled nursing facilities and toward physician services, according to a new analysis.

The study — conducted by Leavitt Partners and the DukeMargolis Center for Health Policy — looked at data from the Medicare Shared Savings Program, which rewarded providers for coordinating care between 2013 and 2016.

 Researchers found that money spent on SNFs decreased, while dollars spent on physicians in accountable care organizations increased. A 1% decrease in spending on SNFs accompanied a 0.82% increase in savings for ACO participants. Overall, ACOs that saved in the first four years spent 0.36% less on inpatient costs, 0.31% less on SNFs and 0.16% less on home health.

“The ACOs that improved their savings rate most rapidly were those that had shifted SNF and inpatient expenditures more dramatically. This finding indicates that the degree to which ACOs shift their expenditures matters and that significant additional savings can be gained by shifting inpatient and SNF spending toward physician services,” authors wrote.

Further research is needed to understand why ACOs are making these moves, and what actions are being taken to decrease dollars toward SNFs, they concluded.