How bundled payments affect healthcare use, quality

Certain bundled payment models can lower costs and maintain or improve quality, but results on healthcare spending and use vary, especially by clinical episode type, according to a study published in Health Affairs.

For the study, researchers reviewed three CMS bundled payment programs: the Acute Care Episode Demonstration, the voluntary Bundled Payments for Care Improvement initiative, and the mandatory Comprehensive Care for Joint Replacement model. Study authors reviewed the programs on spending, utilization and quality outcomes. All the studies were published from 2016-19.

Twenty studies reviewed show that the bundled payment models maintained or improved quality while lowering costs for lower extremity joint replacement. This didn't hold true for other procedures and conditions. Study others added that a significant number of studies didn't find any effect on healthcare spending, although this varied by clinical episode. 

"Our review also suggests that policy makers should account for patient-level heterogeneity and include risk stratification for specific conditions in emerging bundled payment programs," the authors said. 

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