Bundled payment, ACO participation linked to greater readmission reduction

Hospitals that participated in voluntary value-based care programs saw greater readmission reductions than those that chose not to participate, according to a study in JAMA Internal Medicine.

Researchers compared readmission reductions among hospitals that did or did not participate in some of the following programs: meaningful use, the Bundled Payment for Care Initiative episode-based payment program and Medicare's Pioneer and Shared Savings ACO programs.

In 2010, no hospitals were participating in the programs, but by 2015, just 56 out of 2,837 hospitals studied were not participating in at least one value-based care program. Those hospitals experienced a 0.76 percentage point drop in heart attack readmissions, a 1.3 percentage point drop in heart failure readmissions and 0.82 percentage point drop in pneumonia readmissions.

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On the other hand, hospitals participating in just one program saw bigger readmission reductions, and hospitals participating in more than one program saw even bigger gains in readmission reduction. For instance, "participation in all three programs was associated with an additional change in 30-day readmissions of -1.27 percentage points for AMI … -1.64 percentage points for heart failure … and -1.05 percentage points for pneumonia."

The study concludes, "Hospital participation in voluntary value-based reforms was associated with greater reductions in readmissions. Our findings lend support for Medicare's multipronged strategy to improve hospital quality and value."

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