An agent-based simulation model of patient choice of health care providers in accountable care organizations

Abdullah Alibrahim () and Shinyi Wu ()
Additional contact information
Abdullah Alibrahim: University of Southern California
Shinyi Wu: University of Southern California

Health Care Management Science, 2018, vol. 21, issue 1, No 9, 143 pages

Abstract: Abstract Accountable care organizations (ACO) in the United States show promise in controlling health care costs while preserving patients’ choice of providers. Understanding the effects of patient choice is critical in novel payment and delivery models like ACO that depend on continuity of care and accountability. The financial, utilization, and behavioral implications associated with a patient’s decision to forego local health care providers for more distant ones to access higher quality care remain unknown. To study this question, we used an agent-based simulation model of a health care market composed of providers able to form ACO serving patients and embedded it in a conditional logit decision model to examine patients capable of choosing their care providers. This simulation focuses on Medicare beneficiaries and their congestive heart failure (CHF) outcomes. We place the patient agents in an ACO delivery system model in which provider agents decide if they remain in an ACO and perform a quality improving CHF disease management intervention. Illustrative results show that allowing patients to choose their providers reduces the yearly payment per CHF patient by $320, reduces mortality rates by 0.12 percentage points and hospitalization rates by 0.44 percentage points, and marginally increases provider participation in ACO. This study demonstrates a model capable of quantifying the effects of patient choice in a theoretical ACO system and provides a potential tool for policymakers to understand implications of patient choice and assess potential policy controls.

Keywords: Agent-based simulation model; Patient choice; Accountable care organization; Health policy simulation; Congestive heart failure (search for similar items in EconPapers)
Date: 2018
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
http://link.springer.com/10.1007/s10729-016-9383-1 Abstract (text/html)
Access to the full text of the articles in this series is restricted.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:kap:hcarem:v:21:y:2018:i:1:d:10.1007_s10729-016-9383-1

Ordering information: This journal article can be ordered from
http://www.springer.com/journal/10729

DOI: 10.1007/s10729-016-9383-1

Access Statistics for this article

Health Care Management Science is currently edited by Yasar Ozcan

More articles in Health Care Management Science from Springer
Bibliographic data for series maintained by Sonal Shukla () and Springer Nature Abstracting and Indexing ().