We conducted cross-sectional and longitudinal analyses of
Accountable Care Organization (ACO) quality performance
using data from the Centers for Medicare and Medicaid
Services and additional sources. The sample included 322
and 385 Medicare Shared Savings Program (MSSP) ACOs that
had successfully reported quality measures in 2014 and
Results show that after adjusting for other
organizational factors, rural ACOs' average quality score
was comparable to that of ACOs serving other geographic
categories. ACOs with hospital-system sponsorship, larger
beneficiary panels, and higher posthospitalization
follow-up rates achieved better quality performance.
There is no significant difference in average quality
performance between rural ACOs and other ACOs after
adjusting for structural and service provision factors.
MSSP ACO quality performance is positively associated
with hospital-system sponsorship, beneficiary panel size,
and posthospitalization follow-up rate.