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Medicare’s Bundled Payment Program for Joint Replacement

Medicare’s Bundled Payment Program for Joint Replacement Opinion EDITORIAL Promise and Peril? Elliott S. Fisher, MD, MPH The United States is in the midst of a bold experiment. Medi- average organization bore financial risk for only 10 months. care is moving rapidly away from traditional fee-for-service The study compares changes in spending, utilization, and payment. Various alternative payment models (APMs) in- quality for Medicare beneficiaries who underwent lower tended to improve quality extremity joint replacement during a baseline period before and reduce costs are being the BPCI initiative was launched (October 2011 through Sep- implemented or tested. The tember 2012) and the early intervention period (October Related article page 1267 stakes are high. If an evalua- 2013 through June 2015). Episodes delivered at the 176 tion finds that a new model meets the statutory require- BPCI-participating hospitals were compared with a sample ments for expansion, the US Secretary of Health and Human of episodes drawn from a matched sample of 841 nonpar- Services is authorized to expand the models across the coun- ticipating hospitals. All patients at the BPCI hospitals were try. Whether these new programs work and how effectively included (n = 29 441 in the baseline period; n = 31 700 in the they http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Medicare’s Bundled Payment Program for Joint Replacement

JAMA , Volume 316 (12) – Sep 27, 2016

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Publisher
American Medical Association
Copyright
Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2016.12525
pmid
27652520
Publisher site
See Article on Publisher Site

Abstract

Opinion EDITORIAL Promise and Peril? Elliott S. Fisher, MD, MPH The United States is in the midst of a bold experiment. Medi- average organization bore financial risk for only 10 months. care is moving rapidly away from traditional fee-for-service The study compares changes in spending, utilization, and payment. Various alternative payment models (APMs) in- quality for Medicare beneficiaries who underwent lower tended to improve quality extremity joint replacement during a baseline period before and reduce costs are being the BPCI initiative was launched (October 2011 through Sep- implemented or tested. The tember 2012) and the early intervention period (October Related article page 1267 stakes are high. If an evalua- 2013 through June 2015). Episodes delivered at the 176 tion finds that a new model meets the statutory require- BPCI-participating hospitals were compared with a sample ments for expansion, the US Secretary of Health and Human of episodes drawn from a matched sample of 841 nonpar- Services is authorized to expand the models across the coun- ticipating hospitals. All patients at the BPCI hospitals were try. Whether these new programs work and how effectively included (n = 29 441 in the baseline period; n = 31 700 in the they

Journal

JAMAAmerican Medical Association

Published: Sep 27, 2016

References