A mandatory payment bundle for joint replacements saved the Medicare program more than 2% yearly, researchers recently found.
They also discovered that much of the “savings” came through reduced payments to post-acute players.
Participating hospitals cut overall post-acute spending by an average of 5.5%, with payments to skilled nursing providers falling 4.5%, researchers said.
Reviewing Medicare Part A and Part B fee-for-service claims for 815 hospitals assigned to the bundle format, investigators from Harvard’s business and medical schools and Boston-based software analytics firm Avant-garde Health found 90-day spending dropped by about $582 per episode.
The study of the lower extremity Comprehensive Care for Joint Replacement, or CJR, model was published online first in JAMA Internal Medicine.
The cost reduction appeared to be the only significant change brought on by the bundle’s 2016 adoption.
The researchers evaluated levels of spending, quality of care, volume of episodes and patient characteristics and found no detectable changes in hospital length of stay, readmissions, complications, 30- or 90-day mortality, or volume.
Inpatient rehab facilities had it worst, experiencing a 22.9% drop in spending.
