A study in JAMA Internal Medicine investigated changes in internal hospital, quality and 30-day post-acute care spending following Medicare's mandatory Comprehensive Care for Joint Replacement bundled payment model.
The researchers identified 3,942 patients who underwent lower extremity joint replacement at Baptist Health System, one of the approximately 800 hospitals where Medicare launched this program.
Here's what you need to know:
1. During the research period, July 2008 to July 2016, the average Medicare episode expenditures dropped from $26,785 to $21,208 for patients without complications, representing a 20.8 percent decline.
2. The average Medicare episode expenditures dropped from $38,537 to $33,216 for patients with complications, representing a 13.8 percent decline.
3. Readmissions decreased by 1.4 percent, emergency department visits decreased by 0.9 percent and episodes with prolonged lengths of stay decreased by 67 percent; however, patient illness severity did not change over time.
4. The greatest proportion of hospital savings came from reductions in implant costs, which, by 2015, decreased 29 percent per case on average.
5. Overall hospital spending significantly decreased by 2015; 51.2 percent of this saving came from internal cost reductions, while 48.8 percent came from post-acute care spending reductions.
The researchers concluded, "During a period in which Medicare payments for joint replacement episodes increased by 5 percent, bundled payment for procedures at BHS was associated with substantial hospital savings and reduced Medicare payments."