Newer strategies to address high costs and gaps in care may be leaving out vulnerable seniors with complex care needs, a new study has revealed.

Accountable care organizations ideally help seniors better manage health problems requiring intricate coordination such as chronic conditions or frailty.  But an analysis shows they may be missing the mark. Investigators looked at 1.4 million Medicare beneficiaries’ claims and 244 Medicare Shared Savings Program ACO surveys. The examined outcomes were quality of care, healthcare utilization, spending, and interactions with the healthcare system. For patients with complex medical and social needs, investigators found no association between self-reported ACO involvement and outcomes.

“Our results suggest that organizations should consider the effectiveness of investing heavily in care coordination activities that are difficult to implement,” wrote the study’s senior author, Carrie Colla, Ph.D. “As ACOs focus on expanding care coordination and management efforts, it is important to continually evaluate the effectiveness of those programs for different patient populations.”

The study, from The Dartmouth Institute for Health Policy and Clinical Practice, was published in JAMA Network Open.

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