Most of the evidence regarding the success of ACOs is from the Medicare program. This review evaluates the impacts of ACOs within the Medicaid population. We identified 32 relevant studies published between 2012 and 2023 which analyzed the association of Medicaid ACOs and health care utilization ( n = 21), quality measures ( n = 18), health outcomes ( n = 10), and cost reduction ( n = 3). The results of our review regarding the effectiveness of Medicaid ACOs are mixed. Significant improvements included increased primary care visits, reduced admissions, and reduced inpatient stays. Cost reductions were reported in a few studies, and savings were largely dependent on length of attribution and years elapsed after ACO implementation. Adopting the ACO model for the Medicaid population brings some different challenges from those with the Medicare population, which may limit its success, particularly given differences in state Medicaid programs.

中文翻译：

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2012 年至 2023 年医疗补助责任医疗组织对医疗保健利用、质量措施、健康成果和成本的影响：范围界定审查

大多数 ACO 成功的证据来自医疗保险计划。本次审查评估了 ACO 对医疗补助人群的影响。我们确定了 2012 年至 2023 年间发表的 32 项相关研究，这些研究分析了医疗补助 ACO 与医疗保健利用 (n = 21)、质量衡量标准 (n = 18)、健康结果 (n = 10) 和成本降低 (n = 3) 之间的关系）。我们对医疗补助 ACO 有效性的审查结果好坏参半。显着的改进包括增加初级保健就诊次数、减少入院人数和减少住院时间。一些研究报告了成本的降低，成本节省很大程度上取决于归因的长度和 ACO 实施后经过的时间。对医疗补助人群采用 ACO 模式会带来一些与医疗保险人群不同的挑战，这可能会限制其成功，特别是考虑到各州医疗补助计划的差异。