You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Value of Care: Cost and Outcomes Measures III1 Apr 2017PD32-03 IMPACT OF MEDICARE SHARED SAVINGS PROGRAM ACCOUNTABLE CARE ORGANIZATIONS ON PROSTATE CANCER TREATMENT Tudor Borza, Samuel R. Kaufman, Phyllis Yan, Lindsey Herrel, Amy N. Luckebaugh, David C. Miller, Ted A. Skolarus, Bruce L. Jacobs, Edward Norton, Vahakn B. Shahinian, and Brent K. Hollenbeck Tudor BorzaTudor Borza More articles by this author , Samuel R. KaufmanSamuel R. Kaufman More articles by this author , Phyllis YanPhyllis Yan More articles by this author , Lindsey HerrelLindsey Herrel More articles by this author , Amy N. LuckebaughAmy N. Luckebaugh More articles by this author , David C. MillerDavid C. Miller More articles by this author , Ted A. SkolarusTed A. Skolarus More articles by this author , Bruce L. JacobsBruce L. Jacobs More articles by this author , Edward NortonEdward Norton More articles by this author , Vahakn B. ShahinianVahakn B. Shahinian More articles by this author , and Brent K. HollenbeckBrent K. Hollenbeck More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1394AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate cancer is the most common and among the most costly cancer in US men. Uncertainties regarding optimal management lead to treatment variations and increase cost. Accountable care organizations (ACO) can potentially improve care by decreasing variation (i.e. avoidance of treatment in low value settings) and constraining costs. Our objective was to determine the effect of Medicare Shared Savings Program (MSSP) ACOs on prostate cancer care. METHODS Using a 20% Medicare sample we perform a retrospective cohort study of men with newly diagnosed prostate cancer from 2010-2013. We assigned patients to ACOs based on their primary care provider's MSSP ACO participation. We then performed a difference-in-differences analysis comparing the impact of ACO participation on initial prostate cancer curative treatment, treatment of men with a very high 10-year non-cancer mortality risk (i.e. those least likely to benefit) and per beneficiary payments. Outcomes in the post-implementation period were compared to outcomes in the pre-implementation. RESULTS We identified 33,461 men with incident prostate cancer of which 5,015 (15%) were assigned to an ACO. Overall, 58% of men were diagnosed in the pre-ACO implementation period. We noted secular trends in the non-ACO group from pre- to post-implementation in overall curative treatment (4.2% decline, p<0.001), treatment of men with the highest non-cancer mortality risk (6.2% increase, p=0.11) and annual per beneficiary payments 4.0% decrease (p<0.001). ACO participation had no significant effect beyond the secular trend (Figure) on overall treatment or annual payments (difference-in-differences estimator p=0.8, p=0.09, respectively). There was a significant relative decrease in treatment among men with the highest mortality risk of 17% (p=0.03), however did this not lead to differences in cost. CONCLUSIONS Curative treatment of prostate cancer and annual per beneficiary payments decreased significantly between 2010 and 2013. For men diagnosed with prostate cancer, ACO participation did not impact trends in treatment or cost. However, among men least likely to benefit, ACOs resulted in a decline in treatment of prostate cancer. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e589 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Tudor Borza More articles by this author Samuel R. Kaufman More articles by this author Phyllis Yan More articles by this author Lindsey Herrel More articles by this author Amy N. Luckebaugh More articles by this author David C. Miller More articles by this author Ted A. Skolarus More articles by this author Bruce L. Jacobs More articles by this author Edward Norton More articles by this author Vahakn B. Shahinian More articles by this author Brent K. Hollenbeck More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...