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Hospitals in bundled care initiative had greater decline in Medicare payments for joint replacement
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Hospitals that participated in the Bundled Payments for Care Improvement experienced a greater decline in Medicare payments for lower extremity joint replacement episodes compared with hospitals that did not participate in the initiative, according to results.
Between baseline and intervention periods, researchers estimated the differential change in outcomes for lower extremity joint replacement procedures performed on Medicare fee-for-service beneficiaries at 176 Bundled Payments for Care Initiative (BPCI)-participating hospitals and compared this to beneficiaries who underwent the same surgical procedure at matched hospitals that did not participate in the BPCI. Main outcome measures included standardized Medicare-allowed payments, utilization and quality during hospitalization and the 90-day post-discharge period, according to researchers.
Overall, results showed 29,441 and 29,440 lower extremity joint replacement episodes were performed at baseline and 31,700 and 31,696 were performed during the intervention period in BPCI-participating and comparison hospitals, respectively. Researchers noted a decline in mean Medicare episode payments in BPCI-participating hospitals from $30,551 in the baseline period to $27,265 in the intervention period. Comparison hospitals had a decline in mean Medicare episode payments from $30,057 at baseline to $27,938 during the intervention period, which led to an estimated $1,166 more mean Medicare episode payment decline in BPCI-participating hospitals, according to results. Researchers found this decline was primarily due to reduced use of institutional post-acute care. BPCI-participating and comparison hospitals had no significant differences in claims-based quality measures including 30-day unplanned readmissions, 90-day unplanned readmissions, 30-day emergency department visits, 90-day emergency department visits, 30-day post-discharge mortality and 90-day post-discharge mortality, researchers noted. – by Casey Tingle
Disclosures: Dummit reports she owns stock in UnitedHealth Group and is an employee of The Lewin Group. Please see the full study for a list of all other authors’ relevant financial disclosures.
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