How Patients Can Help ACOs Save Money

16 Aug

There are many ways ACOs can save money in the healthcare industry from an administrative perspective. But some of that savings will depend on patients being faithful to their medications, according to a new report.

For example, the report found that if more diabetics took their medication, a Medicare ACO with 10,000 seniors could save $1.1 million on emergency room and hospital visits every year. While thay may not sound like a lot on the national level, that’s only one example. And when you look at it on a national level, the study conservatively estimates $4.7 billion savings a year overall and $2.2 billion to Medicare. The estimates are deemed conservative because the study only included the savings from the cost of hospital stays and emergency room visits, not outpatient care.
While it’s ideal to hope that people will do this independently, there has to be an outside catalyst, if patients do not keep up with their medications already armed with the basic knowledge that it will improve or maintain their health. The researchers did n’t estimate the cost of interventions to boost drug adherence.
“As accountable care organizations and other similar entities form and take greater responsibility for the health and spending of an entire population, focusing on better adherence may be a high-yield activity,” wrote the authors in their report.
The study, published in the journal Health Affairs, examined how closely patients follow their prescriptions. The researchers did so by analyzing three years of data for 135,640 diabetes patients. They tracked changes in prescription use during the first two years (2006 and 2007) and examined hospital and emergency room visits in the third year (2008). They also took into account that some patients could be more ill than others. 
For those patients who didn’t follow their prescriptions during the first year, but who properly took medications in year two, the likelihood of a hospital or emergency room visit dropped 13 percent. The average cost per emergency room visit and hospital stay were $1,502 and $11,575 respectively.
Those patients who started on the right foot and took their medication correctly, but did not continue to do so, the likelihood of a hospital or emergency room visit jumped 15 percent. 
As for how to improve adherence to prescriptions, unfortunately the study did not go down that road.