Date of Degree

5-2023

Document Type

Dissertation

Degree Name

Doctor of Business Administration (DBA)

Program

Business Administration

Advisor

Kruti R. Lehenbauer

Advisor

Rochelle Caroon-Santiago

Advisor

Gregg T. Anders

Abstract

The Centers for Medicare and Medicaid's (CMS) Office of Actuary predicts that U.S. national health expenditures will surpass U.S. gross domestic product per capita by 1.1% annually until 2028, totaling $6.2 trillion in healthcare spending. A significant portion of this spending, 36%, is attributed to Medicare and Medicaid. To address this issue, CMS has implemented the Medicare Shared Savings Program (MSSP) to assist Accountable Care Organizations (ACOs) in reducing healthcare costs and improving the quality of care for beneficiaries. The main objectives of this dissertation are twofold. Firstly, it aims to investigate the relationship between various factors, such as quality score, savings rate, outpatient and inpatient emergency department visits, total primary care visits, total number of beneficiaries, and risk model selected, with the total savings or loss generated by MSSP ACOs during the 2019 and 2021 performance years. Secondly, this dissertation seeks to assess the impact of the 2020 COVID-19 Federal health response on these parameters, both before and after the pandemic, including the generated total savings, quality score, savings rate, outpatient and inpatient emergency department visits, total primary care visits, number of beneficiaries, and risk model selected. The analysis reveals sustained direct relationships over the three-year period between generated total savings or loss, savings rates, and the number of beneficiaries. Additionally, quality scores, outpatient and inpatient emergency department visits show a decline during the same period.

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