Insights

New Analysis Explores Ways for Accountable Care Organizations to Reduce Costs Through Less Expensive Drugs for Age-Related Macular Degeneration

Salt Lake City, May 12, 2020 – New analysis from Leavitt Partners and CareJourney explores ways in which accountable care organizations (ACOs) can reduce health care costs without potentially impacting their beneficiaries’ quality of care.  One such opportunity for ACOs lies in switching patients to similarly effective but less-expensive medications for particular conditions. Our analysis of Medicare claims data from 2014 to 2016 indicates that switching to the least expensive drug for one cohort of patients can make a meaningful impact on total ACO cost performance.

A summary of this analysis can be found in the white paper entitled “ACOs and Age-Related Macular Degeneration (AMD): Practice Patterns Impact Savings.” In 2016, a quarter of ACOs that saved money for Medicare but did not qualify for a bonus payment would have qualified for a bonus payment if they had used the lower-cost drug. Small adjustments such as these could present large opportunities for ACOs to achieve savings without sacrificing quality of care.

“We found that switching certain patients to the least expensive drug approved to treat age-related AMD would have yielded significant savings for ACOs, including 62 times over the three-year period that ACOs would have qualified for a bonus payment but didn’t,” said David Muhlestein, Ph.D., JD, Chief Strategy and Chief Research Officer at Leavitt Partners.

Aneesh Chopra, president for CareJourney said, “We understand that clinical, and in this case, logistical factors that inform the selection of otherwise clinically-equivalent AMD therapies, but felt it was significant that the total savings for the Medicare MSSP program would have been $680 million in 2016 if all AMD patients had been switched to the lower-cost medication.”

As ACOs continue on their path toward value-based care, their search for targeted interventions for cost savings should include further exploration into the opportunities presented by lower-cost medication for beneficiaries.

 

The white paper can be viewed here.

 

About Leavitt Partners:

Leavitt Partners is a health care intelligence business. The firm helps clients successfully navigate the evolving role of value in health care by informing, advising, and convening industry leaders on value market analytics, alternative payment models, federal strategies, insurance market insights, and alliances. Through its family of businesses, the firm provides investment support, data and analytics, member-based alliances, and direct services to clients to support decision-making strategies in the value economy. For more information please visit www.LeavittPartners.com.

Contact: Julie Sommer, Vice President of Marketing, 720.244.2138 or [email protected]

About CareJourney:

CareJourney is a leading provider of clinically-relevant analytics for value-based networks. Headquartered in Arlington, VA, CareJourney currently supports leading payer, provider, and life sciences organizations across the US in achieving their goals by wringing new, high value insights out of expansive population claims data. Through its CareJourney Platform, CareJourney provides members with interactive dashboards of clinically-relevant insights around network design and management, care model management, patient risk segmentation, spend and utilization trends, network integrity, low-value care, and provider, practice and facility (acute and post-acute) performance. For more information, please visit us at www.carejourney.com.

Contact: Deepika Kumar, Chief Marketing Officer [email protected]