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AHRQ Compendium Update Show Health Systems’ Growing Participation in ACOs

In 2017 AHRQ launched its Compendium of U.S. Health Systems. As part of their ongoing initiative to explore how health system consolidation may be affecting quality and cost, AHRQ has updated the compendium to include information on how many systems are augmenting patient care services by offering health insurance plans, participating in Accountable Care Organizations (ACOs), and participating in Medicare bundled payment programs.

The compendium’s new hospital linkage file contains comprehensive information on all of the hospitals within each system, greatly increasing the utility of the resource by allowing researchers to link the data in the compendium to other available sources of hospital data.

AHRQ also has developed four new data highlight publications that summarize the newly included data, while noting in particular that a significant share of systems are participating in alternative payment programs and offering health plans. These summaries feature insights into health systems’ participation in ACOs, Medicare Advantage plans, and Medicare bundled payment models, as well as systems’ provider-offered insurance products.

The summaries identify important overall trends. Hospitals in health systems, for example, are much more likely than non-system hospitals to participate in alternative payment models, such as Medicare’s Comprehensive Joint Replacement Bundled Payment and the Bundled Payment for Care Improvement Program. And larger systems that own four or more hospitals are much more likely to participate in alternative payment plans and offer insurance products.

The highlights also show how participation in alternative payment programs and insurance offerings differ by other system characteristics, such as academic affiliation and ownership type (public, investor owned or nonprofit) and level of uncompensated care.

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