Medicare bundles lead to some hospital savings, but mortality rates stay flat, study says

Long-term participation in Medicare bundled payment initiatives generated some savings for hospitals, but little change in mortality outcomes, according to a study published in the BMJ.

For the analysis, researchers from the Corporal Michael J. Crescenz VA Medical Center in Philadelphia, the University of Washington School of Medicine in Seattle and the University of Pennsylvania in Philadelphia examined hospitals in bundled payment programs for heart attacks, heart failure, chronic obstructive pulmonary disease and pneumonia. The researchers compared 226 hospitals in the bundled payment programs with 700 hospitals that weren't. 

The study authors found hospitals that participated in the bundled payment programs saw episode spending fall by about 1.2 percent. Spending on skilled nursing facilities fell 6.3 percent, but home health spending grew 4.4 percent. At the same time, mortality rates at 90 days didn't change.

"Participation in bundles for four common medical conditions was associated with savings at three years. The savings were generated by practice changes that decreased use of high intensity care after hospital discharge without affecting quality, which also suggests that bundles for medical conditions could require multiple years before changes in savings and practice emerge," the study authors concluded.

Read the full study here

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