Bundled pay cuts LOS, use

The Bundled Payments for Care Improvement initiative is already showing promising results, researchers said.

The average length of stay at a skilled nursing facility for residents who underwent orthopedic surgery through the program averaged 1.3 days shorter, on average, than those who didn't.

This is according to the second annual evaluation of the BPCI program by the Lewin Group, a Virginia-based research firm contracted by the Centers for Medicare & Medicaid Services. The report analyzed around 60,000 episodes of care initiated between October 2013 and September 2014.

Lengths of stay for beneficiaries discharged from non-BPCI hospitals “remained virtually unchanged,” report authors wrote.

The overall use of institutional post-acute care services by orthopedic surgery patients in bundled payment models also dropped from 64% to 57% during the study period — a greater decline than beneficiaries in traditional payment models, Lewin's investigators noted. Uses of institutional post-acute care for cardiovascular surgery patients showed similar patterns.

Another study focused on the outcomes of hip and knee replacements in the BCPI initiative found the program has reduced Medicare costs but not produced significant changes to care quality.