Effect of the Bundled Payments Care Improvement Initiative on Health-Care Spending – Physician's Weekly

Effect of the Bundled Payments Care Improvement Initiative on Health-Care Spending – Physician's Weekly

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Jun 22, 2022
For a study, researchers sought to determine if major bowel participating Bundled Payment for Care Improvement organizations save more money on colectomy while maintaining satisfactory quality outcomes when compared to nonparticipating organizations. This was an analysis of all participating hospitals in the Bundled Payments for Care Improvement program for major bowel procedures (major bowel group) and propensity score-matched against Bundled Payments for Care Improvement organizations that do not include major bowel procedures (nonmajor bowel group) and those that did not participate in any Bundled Payments for Care Improvement program (non-Bundled Payments for Care Improvement group). Patients in the Medicare Standard Analytic file within Medicare Severity Diagnosis-Related Groups 329–331 at participating facilities between January 1, 2011, and June 30, 2016. The primary outcome measures were average total care expenditure and quality of care (length of stay, morbidity, and mortality) from 3 days before surgery to 90 days after surgery. Investigators collected 7,609 major bowel episodes from 23 major bowel group facilities, 21,872 major bowel episodes from nonmajor bowel-matched hospitals, and 19,383 major bowel episodes from non-Bundled Payments for Care Improvement–matched hospitals. They found a $2,955 average reduction in care expenditures from the baseline period (January 2011 to June 2012) to the final (July 2015 to June 2016). Compared to the other groups, the major bowel group had the greatest decrease in average total episode expenditure (14%) (6% reduction for nonmajor bowel and 5% reduction for non-Bundled Payments for Care Improvement). Using a generalized estimating equation to account for patient demographics, comorbidities, and hospital characteristics, the average total episode expenditure for the major bowel group, was $4,885 (95% CI $4,838–$4,932; P<0.001) lower than the non-Bundled Payments for Care Improvement group was $2,050 (95% CI $2,038–$2,061). The length of stay, 30-day and 90-day complication rates, and readmission rates were reduced in all groups. Participation in Bundled Payments for Care Improvement for major bowel procedures resulted in a greater decrease in average total cost per episode of care than in nonparticipating hospitals without compromising care quality.
Source:journals.lww.com/dcrjournal/Fulltext/2022/06000/Impact_of_Bundled_Payment_Care_Improvement.11.aspx
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