Date of Conferral

2021

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Services

Advisor

Matt Frederiksen-England

Abstract

In 2018, Medicare spending in the United States accounted for 15% of the comprehensive federal budget forecasted to exceed $1.5 trillion by the year 2028. To help manage the spending in this sector, the Centers for Medicare and Medicaid Services implemented Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs). There is a need to understand current data as it relates to the correlation between MSSP ACO participants’ costs, quality, and assigned beneficiaries. The purpose of this quantitative study was to examine the relationship between Quality Score, Generated Total Savings/Losses and Total Assigned Beneficiaries for 2018 MSSP ACO participants. General systems theory was the theoretical base that grounded and conceptualized this study. The key research questions examined the relationship between the Quality Score and Generated Total Savings/Losses for 2018 MSSP ACO participants and the relationship between the Quality Score and Total Assigned Beneficiaries for 2018 MSSP ACO participants. The research design was that of secondary data quantitative analysis. The analytics stem from public CMS data. Even though the data analysis results showed no statistically significant relationship between Quality Score and Generated Total Savings/Losses nor between Quality Score and Total Assigned Beneficiaries for 2018 MSSP ACO provider participants, this study contributed to positive social change by creating a new vantage point for review of their quality, costs, and assigned beneficiaries. The development and understanding of ACO initiatives are essential pieces required for meeting federal value-based care and alternative payment model U.S. health care goals.

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