Summary

Targets: Initial, to evaluate irrespective of whether hospitals develop the community breadth of their wellness information exchange (HIE) associates right after joining an accountable treatment business (ACO). 2nd, to evaluate whether or not this HIE network expansion outcome differs throughout markets with differing concentrations of ACO penetration.

Examine Layout: Change-in-variations analyses of US nonfederal acute care hospitals, 2014-2017.

Techniques: We used details from the American Healthcare facility Affiliation Once-a-year Survey and Information and facts Technologies Dietary supplement to measure hospital ACO participation, HIE network breadth (outlined as number of unique husband or wife varieties), and ACO current market penetration at the hospital referral area stage. We carried out a difference-in-distinctions product to estimate alterations in hospitals’ HIE community breadth with ACO participation in unique yrs. We estimate these outcomes mixed throughout all marketplaces and stratified by markets with high and lower ACO industry penetration.

Benefits: In merged analyses, HIE breadth improved by .35 associate types with ACO participation, a 30.7% increase (P < .001). In stratified analyses, this effect was larger for hospitals in high–ACO penetration markets (0.41 partner types, a 32.0% increase P < .001) and smaller for hospitals in low–ACO penetration markets (0.25 partner types, a 24.8% increase P < .05). We found dynamic effects of ACO adoption illustrating an immediate effect in high–ACO penetration markets and a 2-year delayed effect in low–ACO penetration markets.

Conclusions: Hospitals that joined ACOs increased their HIE breadth, but this effect was heterogenous across markets and across time. Our findings illustrate a “network effect,” with large, immediate effects in HIE breadth following ACO participation in high–ACO penetration markets and smaller, delayed effects in low–ACO penetration markets.

Am J Manag Care. 202228(1):In Press

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Takeaway Points

Accountable care organization (ACO) success depends in part on a broad network of health information exchange (HIE) partners to effectively coordinate care. Our study illustrates that although ACO participation broadens HIE networks, the…