Bundled payment programs curbed unnecessary care, costs, over 4-year period, report asserts

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Value-based care models, including bundled payments for hip and knee replacements, reduce costs and unnecessary care, according to a new analysis.

The Altarum Institute's Center for Payment Innovation authors — which include Patrick Conway, M.D., Deputy Administrator for Innovation & Quality and the Chief Medical Officer at the Centers for Medicare & Medicaid Services — examined Medicare Part A Claims and hospitals participating in the Bundled Payment for Care Improvement program from 2011 to 2015.

Their research indicates bundled payments had increased quality metrics and lowered the costs without increasing the volume of episodes, they wrote.

A 2016 piece in the American Medical Association's JAMA that was more critical of BPCI failed to look at differences in Medicare beneficiaries in local areas as well as differences in regional prevalence for joint procedures, they said. The Altarum authors said they found providers that went into BPCI in October 2013 and January 2014 had a rate of increase below baseline and performance years significantly lower than the national rate.

“Our study definitively disputes any assertion that the BPCI-participating hospitals contributed to a higher volume of procedures as a result of that participation. In fact, the opposite is true,” they wrote. “The rate of increase in the volume of procedures was significantly lower than in the rest of the country.”