Bundled payments for breast cancer screening feasible, study says

As adoption of bundled payments grows, researchers are exploring the model's feasibility in breast cancer screening episodes, especially given widespread use of new technologies in addition to mammography.  

In a study published Jan. 22 in the Journal of the American College of Radiology, researchers examined four-year data for 59,094 screening episodes from two large academic health system facilities. Study authors aimed to see how greater use of new technologies like digital breast tomosynthesis affected prices.

When digital breast tomosynthesis was excluded from the study, Medicare prices for traditional breast imaging 364 days downstream to screening mammography were similar before [$182.86 in 2013] and after digital breast tomosynthesis implementation [$182.68 in 2015].

When digital breast tomosynthesis was added, the bundled price increased by $53.16. However, the addition was linked with significantly reduced recall rates. Whether or not digital breast tomosynthesis was included, bundled payment prices for breast cancer screening remained sensitive to services included in the bundle, but did not vary much by patient age, race or insurance plan.

"Prior non-DBT approaches to bundled payment models for breast cancer screening remain viable as DBT becomes the standard of care, with bundle prices varying little by patient age, race, or insurance status," the study authors concluded. "Higher DBT-inclusive bundled prices, however, highlight the need to explore societal costs more broadly [eg, reduced time away from work from fewer recalls] as bundled payment models evolve."

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