Commercial accountable care organizations, like those implemented in Massachusetts, save the consumer and the government money after the second year of operation according to an analysis conducted by Dr. J. Michael McWilliams of Harvard Medical School and colleagues that was reported in the Aug. 27, 2013, issue of the Journal of the American Medical Association.
The researchers examined the costs to Medicare recipients and the effectiveness of Blue Cross Blue Shield's (BCBSMA) Alternative Quality Contract (AQC) in Massachusetts in reducing costs and improving the quality of medical care provided to BCBSMA mwmbers and to Medicare recipients that were not enrolled in BCBSMA. The study compared the costs and quality of service between 2007 and 2010 for people in the AQC and people who were not in the AQC.
Two years after implementation, the AQC was found to have reduced costs by $99 per patient on average. This saving is a 3.4 percent of the expected quarterly expenditure for each patient. The cost reduction increased to $125 for persons who had more than five health conditions that required medication or treatment.
The researchers noted that the implementation of an AQC program accomplished similar cost savings for persons not insured by BCBSMA due to what the authors term a spillover effect.
The majority of savings came from a reduction in out patient costs, emergency room visits, imaging, and lab tests. The increased emphasis on quality of service reduced the rates of cardiovascular disease in the test group by 2.5 percent.
The researchers conclude that a properly implemented and administered commercial accountable care organization has the potential to pay for itself after two years.