The adoption and spread of hospital care coordination activities under value-based programs

Academic Article


  • OBJECTIVES: To examine the relationship between participation in value-based programs and care coordination activities. STUDY DESIGN: Cross-sectional, observational study of 1648 US hospitals using the American Hospital Association (AHA)’s 2013 Survey of Care Systems. Value-based program participation included participation in either an accountable care organization (ACO) or a bundled payment program. We assessed adoption (whether a hospital was using any of a set of 12 care coordination activities in the AHA survey) and spread (in each hospital adopting care coordination activities, how extensively those activities were implemented throughout the hospital). METHODS: Ordinary least squares regression assessed associations between participation in an ACO or bundled payment program and the adoption and spread of 12 care coordination activities. RESULTS: Hospitals adopted nearly two-thirds of the possible care coordination activities (mean [SD] = 7.9 [4.4] of 12). Among those hospitals adopting care coordination activities, there was a relatively moderate spread of these activities (mean = 2.5; range, 1 [minimally used] to 4 [used hospitalwide]). Hospital participation in an ACO was associated with the adoption of 3.07 more care coordination activities (P <.001), on average, and 0.16 more points on the scale of spread of care coordination activities (P <.001) compared with hospitals that were not participating in an ACO. Hospital participation in a bundled payment program was associated with the adoption of 1.84 more care coordination activities (b = 1.84; P <.001) but not greater spread (b = –0.04; P = .54). CONCLUSIONS: Value-based programs such as ACOs appear to encourage the adoption and spread of care coordination activities by hospitals.
  • Published In

    Author List

  • Hearld LR; Carroll N; Hall A
  • Start Page

  • 397
  • End Page

  • 404
  • Volume

  • 25
  • Issue

  • 8