This piece originally appeared on the Health Affairs Blog.
At LDI’s 50th Anniversary Symposium, participants in the panel “The Future of Payment Reform” characterized and evaluated different alternative payment models (APMs) such as bundled payments and accountable care organizations (ACOs).
Association Between Hospital Participation in a Medicare Bundled Payment Initiative and Payments and Quality Outcomes for Lower Extremity Joint Replacement Episodes
In JAMA, Laura Dummit and colleagues, including Matthew Press, evaluate whether a Centers for Medicare and Medicaid Services (CMS) bundled payment pilot program is associated with a reduction in Medicare payments. Specifically, the authors assess if Bundled Payments for Care Improvement (BPCI) reduced Medicare payments and maintained quality in lower extremity joint replacement. This CMS program was launched in 2013 to test whether linking payments for services provided during an episode of care can reduce Medicare payments and maintain quality. The authors used a difference-in-...
This brief reviews the evidence on how key ACA provisions have affected the growth of health care costs. Coverage expansions produced a predictable jump in health care spending, amidst a slowdown that began a decade ago. Although we have not returned to the double-digit increases of the past, the authors find little evidence that ACA cost containment provisions produced changes necessary to “bend the cost curve.” Cost control will likely play a prominent role in the next round of health reform and will be critical to sustaining coverage gains in the long term.
This is the way it is supposed to work. You develop policy and processes to drive innovation. You design and test innovative ideas in a small, efficient way. You learn and adapt. Successful innovation drives new policy. Rinse and repeat.
And this is the way it appears to have worked, in the case of Medicare bundled payment. Start small with a pilot. Expand in reach and scope if promising. Scale up if successful.
Evidence on the effects of bundled payment is more important than ever, while hospitals already in Medicare bundled payment programs need guidance in redesigning care. This observational study looks at whether bundled payment for joint replacement affected quality, hospital costs and post-acute care spending in a health system that was an early adopter of the model. Did the bundles save money, and if so, what produced those savings?
The election of Donald Trump has ushered in an uncertain future for the Affordable Care Act (ACA), from modification to total repeal. While many policy experts are concerned about people losing the coverage they gained through the ACA, other aspects of the ACA are also under threat: specifically, provisions that address the social determinants of health.
The notion of value is at once one of the most widely invoked and variably interpreted in American health care.
[cross-posted from the Health Cents blog on philly.com]
The projected growth, and widespread variation, in the cost of joint replacement surgeries prompted Medicare to introduce a bundled payment plan for these procedures. In a new JAMA Viewpoint, Said Ibrahim, a LDI Senior Fellow and Co-Director of the VA’s Center for Health Equity Research and Promotion, and co-authors Hyunjee Kim and K.
As a recipient of the Alice Hersh Scholarship, I had the privilege of attending AcademyHealth’s 2015 National Health Policy Conference in Washington D.C. In addition to many interesting sessions, I had the opportunity to meet many leaders in the health care space, from health services researchers and policy makers to providers and business leaders.
As the Affordable Care Act’s health insurance marketplaces begin their second year of open enrollment, LDI examines the current and potential impact of the ACA on the health of minority populations. This third post of a five-part series examines how new models of care delivery encouraged by reform will affect minority populations.
Abstract: Physician-to-physician referrals play a central role in the health care systems and are drives of costs and quality. There is evidence that referrals are currently misused and overused and recognition that they will have to change if health reform objectives such as care coordination and cost reduction are to be achieved (Son et al., 2014). Indeed, many of the models of care supported by the Affordable Care Act (e.g., accountable care organizations (ACOs), patient-centered medical homes, bundled payments) depend on physicians making high-value referrals.