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

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

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 years^a	292 (274–311)	328 (309–348)	0.01
30-day acute care readmissions per 1000 discharges^a	146 (141–152)	156 (150–162)	0.02
Post discharge (30 day) provider visits per 1000 discharges^a	757 (748–765)	776 (767–785)	0.01
Skilled nursing facility discharges per 1000 person years^a	73 (61–85)	106 (93–119)	0.001
Emergency Department visits per 1000 person years^a	680 (639–722)	756 (711–800)	0.02
Physician/supplier spending per assigned beneficiary^a	$3296 (3112–3479)	$3165 (2970–3360)	0.36
Acute care hospital spending per assigned beneficiary^a	$2774 (2561–2987)	$3180 (2953–3407)	0.02
Skilled nursing facility spending per assigned beneficiary^a	$818 (642–993)	$1199 (1063–1437)	0.002
Savings per beneficiary per year	$87 ($-104–$278)	$-142 ($-346–$61)	0.13

^aAdjusted for number of beneficiaries, percent non-white beneficiaries, percent dual eligible, percent age over 74 years, census division and months in ACO
E&M Evaluation and management
PCP Primary care physician

ISSN: 1472-6963