Researchers from Dartmouth College and the University of Michigan have discovered that the implementation of pilot accountable care organizations at 10 large health systems did not limit spending on discretionary or non-discretionary cardiovascular treatment for patients.

“We found that, when an ACO payment model was implemented, evidence-based treatments for patients with cardiovascular disease, such as heart attack or stroke, were provided consistently,” said lead author Carrie Colla, a health economist at Dartmouth. "That's a good thing. However, we also found that discretionary tests and procedures, such as stress tests for people without symptoms, were still being commonly ordered. We hypothesized that pilot ACOs would target these discretionary treatments to help lower spending, but that didn't happen. For ACOs, which need to focus on limiting spending on discretionary treatments, this is a missed opportunity."

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