A new study published in Spine examines how Medicare's Bundled Payment for Care Improvement program for lumbar spinal fusion has affected outcomes.
Study authors examined data from Medicare patients who underwent spinal fusions as fee-for-service beneficiaries in 2012 or 2013 and compared their outcomes to patients who had surgery after the BPCI program was initiated in 2013. There were 89,605 beneficiaries included in the study with 36 percent seen at a preparatory hospital and 7 percent at a risk-bearing hospital.
Study authors found:
1. There was a 3.4 percent increase in fusion volume at risk-based institutions from 2012 to 2013, compared to 1.6 percent decrease among non-BPCI participating hospitals.
2. The risk-bearing hospitals reported a 0.4 percent decrease in the 90-day episode of care costs, compared to a 2.9 percent decrease among non-participating hospitals.
3. The risk-bearing hospitals reported a 2.7 percent increase in readmissions, compared to a 10.7 percent decrease at non-participating hospitals.
4. Repeat surgeries were up 30.6 percent among the risk-bearing hospitals, compared to 7.1 percent among the non-participating hospitals.
"Early findings suggest unintended and potentially harmful effects of the BPCI program for lumbar fusion, suggesting an imperative for continued monitoring of the program," study authors concluded.