To the Editor We write to report and explain errors that occurred in the Original Investigation, titled “Association Between Medicare Accountable Care Organization Implementation and Spending Among Clinically Vulnerable Beneficiaries,”¹ that was published online on June 20, 2016, and in the August 2016 issue of JAMA Internal Medicine. The article reported the results of a cohort study designed to estimate the association between Medicare accountable care organization (ACO) contracts with spending and high-cost institutional use for the overall Medicare population and a clinically vulnerable subgroup of Medicare beneficiaries from January 2009 through December 2013. The main outcome measures of our study were total spending per beneficiary-quarter, spending categories, use of hospitals and emergency departments, ambulatory care–sensitive admissions, and 30-day readmissions. We determined that the Medicare ACO programs were associated with modest reductions in spending and use of hospitals and emergency departments and that savings were realized through reductions in use of institutional settings in clinically vulnerable patients.

致编辑我们写信报告并解释在原始调查中发生的错误，该调查的标题为“医疗保险责任医疗组织实施与临床弱势受益人的支出之间的关联”，¹于2016年6月20日在线发布，并于2016年8月发布发行JAMA内科。这篇文章报道了一项队列研究的结果，该研究旨在估计2009年1月至2013年12月间，医疗保险责任医疗组织（ACO）合同与整个医疗保险人群的支出和高成本机构使用以及医疗保险受益人的临床脆弱人群之间的关联。我们研究的主要结果指标是每个受益人季度的总支出，支出类别，医院和急诊室的使用，对非卧床护理敏感的入院和30天的再入院。我们确定，Medicare ACO计划与医院和急诊部门的开支和使用的适度减少有关，并且通过减少临床上脆弱的患者对机构设置的使用实现了节省。