Bundled payment outcomes vary between surgical and medical episodes, according to Health Affairs.
Here are five things to know:
1. CMS’ evaluation of the Bundled Payments for Care Improvement model demonstrated that participation in joint replacement bundles is associated with a 3.8 percent decrease in per-episode spending with stable-to-improved quality.
2. According to a JAMA Internal Medicine study, bundled payments may reduce the cost of joint replacement episodes by 20.8 percent, benefitting hospitals, physicians and improving patient care.
3. Bundles for medical conditions, such as congestive heart failure and chronic obstructive pulmonary disease, however, are not associated with significant changes in Medicare spending or quality, according toNEJM.
4. CMS has emphasized reductions in post-acute utilization and spending, which better suits surgical than medical care. Hospitalization and skilled nursing facility care is often time-limited in surgical episodes, which is not the case in medical episodes, such as congestive heart failure and chronic obstructive pulmonary disease.
5. Patients in medical bundles also tend to be older and at greater risk of poverty and disability than joint replacement surgical bundle patients.
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