Impact of Accountable Care Organizations on Prostate Cancer Screening and Biopsies in the United States

AbstractIntroduction:Accountable care organizations are designed to financially incentivize efficiency and reduce low value care. To determine if accountable care organizations have impacted prostate cancer screening patterns, we analyzed trends in prostate specific antigen screening and prostate biopsies by accountable care organization and nonaccountable care organization providers.Methods:Using a random 20% sample of Medicare claims, we selected men 66 years old or older. In 2014 beneficiaries were attributed to accountable care organization and nonaccountable care organization providers using a modified Medicare Shared Savings Program algorithm. Beneficiaries treated by these same providers in 2010 served as the control population. Inverse probability weighting and difference in differences analyses were used to compare trends in prostate specific antigen screening and prostate biopsies in 2010 and 2014. Analyses were stratified by the age groups 66 to 69 years old and 70 years old or older.Results:Am...