# Effects of accountable care organizations on post-acute care

> **NIH AHRQ R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2020 · $382,235

## Abstract

Post-acute care is one of the fastest growing areas of US healthcare spending. About 40% of older
Americans discharged from a hospital utilize post-acute care, and spending in this area has more than
doubled in the past decade. To hold providers responsible for longitudinal care, Medicare is testing
accountable care organizations (ACOs) in two pilot programs: the Medicare Shared Savings Program
(MSSP) and the Pioneer ACO program. The impact of these efforts on both Medicare spending and
patient outcomes remains uncertain, however. To the extent that post-acute care (PAC) spending is
reduced, understanding whether lower costs occur through reductions in the quantity or intensity of
post-acute care, or both, will be important. Furthermore, ACOs vary widely in their organizational
structure and risk models (e.g., stronger vs. weaker PAC engagement; and more vs. less risk-sharing).
The magnitude of any changes in PAC utilization will plausibly be modified by ACO heterogeneity. Apart
from the effects of ACOs on post-acute care utilization and spending, there is also considerable
uncertainty about how any changes in post-acute care will impact key clinical outcomes such as
mortality. Therefore, we propose to use national Medicare data to carry out three aims: 1) To evaluate
the impact of ACOs on post-acute care spending and utilization; 2) To describe how ACO heterogeneity
modifies ACOs’ effects on post-acute care spending; and 3) To evaluate the impact of changes in post-
acute care spending and utilization on patient outcomes.

## Key facts

- **NIH application ID:** 9984359
- **Project number:** 5R01HS024698-05
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Julie PW Bynum
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2020
- **Award amount:** $382,235
- **Award type:** 5
- **Project period:** 2016-09-30 → 2023-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9984359

## Citation

> US National Institutes of Health, RePORTER application 9984359, Effects of accountable care organizations on post-acute care (5R01HS024698-05). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9984359. Licensed CC0.

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