Use of PACs and post-surgical outcomes in urologic cancer surgery

For one study, researchers sought to assess the relationship between post-acute care (PAC) utilization and cost in Medicare Accountable Care Organizations (ACOs), hospital involvement, and post-acute outcomes. -surgical in Medicare beneficiaries having urological cancer procedures. The use of Accountable Care Organizations (ACOs) in the treatment of urologic cancer has not been well studied, despite recent innovations in Medicare payment, including Accountable Care Organizations and increasing rates urological cancer and surgical care representing a significant percentage of overall health care expenditure.

To assess post-surgical outcomes between Medicare ACO and non-ACO patients before and after the adoption of the Medicare Shared Savings Program (MSSP), they conducted a longitudinal study of Medicare claims data from 2011-2017. Outcomes of interest were post-acute care (PAC) utilization (general, institutional, and home health), length of stay in skilled nursing (SNF) facilities, Medicare expenditures for SNF patients , unplanned readmissions at 30 and 90 days after surgery index and complications.

A total of 334,514 Medicare patients who underwent surgery for kidney, bladder, or prostate cancer at 2,066 non-ACO hospitals and 524 Medicare ACO hospitals comprised the study sample. Participation in a Medicare ACO was linked to significantly lower total use of post-acute care for bladder cancer surgery, but not to changes in readmission or complication rates. They found no evidence of an association between hospital participation in Medicare ACOs and use of PACs or post-surgical outcomes for prostate cancer or kidney cancer surgery.

Participation in MSSP ACOs by hospitals reduces the need for post-acute care without affecting patient outcomes for Medicare beneficiaries undergoing surgery for bladder cancer. Future studies were needed to understand the longer-term effects of OAC adherence on the outcomes of urologic cancer surgery.


Christine E. Phillips