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Table 2 Utilization and spending in ACOs with least and greatest PCP focus

From: Primary care focus and utilization in the Medicare shared savings program accountable care organizations

Metric (95% CI) Least PCP focus Greatest PCP focus p-value
Total E&M visits per 1000 person years 9957 (9511–10,403) 10,664 (10,139–11,188) 0.04
E&M visits by a PCP per 1000 person years 3131 (2820–3440) 5561 (5202–5920) <0.001
E&M visits by a specialist per 1000 person years 5065 (4617–5513) 4319 (4044–4595) 0.005
Acute care hospital discharges per 1000 person yearsa 292 (274–311) 328 (309–348) 0.01
30-day acute care readmissions per 1000 dischargesa 146 (141–152) 156 (150–162) 0.02
Post discharge (30 day) provider visits per 1000 dischargesa 757 (748–765) 776 (767–785) 0.01
Skilled nursing facility discharges per 1000 person yearsa 73 (61–85) 106 (93–119) 0.001
Emergency Department visits per 1000 person yearsa 680 (639–722) 756 (711–800) 0.02
Physician/supplier spending per assigned beneficiarya $3296 (3112–3479) $3165 (2970–3360) 0.36
Acute care hospital spending per assigned beneficiarya $2774 (2561–2987) $3180 (2953–3407) 0.02
Skilled nursing facility spending per assigned beneficiarya $818 (642–993) $1199 (1063–1437) 0.002
Savings per beneficiary per year $87 ($-104–$278) $-142 ($-346–$61) 0.13
  1. aAdjusted for number of beneficiaries, percent non-white beneficiaries, percent dual eligible, percent age over 74 years, census division and months in ACO
  2. E&M Evaluation and management
  3. PCP Primary care physician