BPCI hospitals see similar Medicare payments as other hospitals, study suggests

Hospitals participating in five common medical bundles under CMS' Bundled Payments for Care Improvement program did not see significant changes in Medicare payments or quality metrics when compared to control hospitals, according to a study published in The New England Journal of Medicine.

The study, funded by liberal think tank the Commonwealth Fund, studied Medicare claims from 2013 through 2015 to identify admissions for BPCI's most common bundles: congestive heart failure, pneumonia, chronic obstructive pulmonary disease, sepsis and acute myocardial infarction. Researchers affiliated with Boston-based Brigham and Women's Hospital, Boston-based Harvard T.H. Chan School of Public Health and St. Louis-based Washington University School of Medicine compared how Medicare payments per episode of care for hospitals participating in the five bundled payment programs compared with payments for control hospitals.

The study examined 492 hospitals participating in one of the five bundles. BPCI hospital claims showed the average Medicare payment per episode of care across the five conditions was $23,993, down from a baseline average of $24,280. Control hospitals' average Medicare payment per episode of care was $23,503, down from a baseline of $23,901.

When compared to control hospitals, BPCI hospitals also did not see significantly different quality results, according to the study. Researchers concluded clinical complexity, length of stay, emergency department use, readmission within 30 or 90 days post-discharge, or death within 30 to 90 days after admission changed little between BPCI and control hospitals.

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