• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Annals of Internal Medicine >Spillover Effects of Medicare's Voluntary Bundled Payments for Joint Replacement Surgery to Patients Insured by Commercial Health Plans.
【24h】

Spillover Effects of Medicare's Voluntary Bundled Payments for Joint Replacement Surgery to Patients Insured by Commercial Health Plans.

机译：Medicare自愿捆绑支付对商业卫生计划保险的患者联合替代手术的溢出效应。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Under the Bundled Payments for Care Improvement (BPCI) program, bundled paymtents for lower-extremity joint replacement (LEJR) are associated with 2% to 4% cost savings with stable quality among Medicare fee-for-service beneficiaries. However, BPCI may prompt practice changes that benefit all patients, not just fee-for-service beneficiaries. To examine the association between hospital participation in BPCI and LEJR outcomes for patients with commercial insurance or Medicare Advantage (MA). Quasi-experimental study using Health Care Cost Institute claims from 2011 to 2016. LEJR at 281 BPCI hospitals and 562 non-BPCI hospitals. 184?922 patients with MA or commercial insurance. Differential changes in LEJR outcomes at BPCI hospitals versus at non-BPCI hospitals matched on propensity score were evaluated using a difference-in-differences (DID) method. Secondary analyses evaluated associations by patient MA status and hospital characteristics. Primary outcomes were changes in 90-day total spending on LEJR episodes and 90-day readmissions; secondary outcomes were postacute spending and discharge to postacute care providers. Average episode spending decreased more at BPCI versus non-BPCI hospitals (change, -2.2% [95% CI, -3.6% to -0.71%]; P ?= 0.004), but differences in changes in 90-day readmissions were not significant (adjusted DID, -0.47 percentage point [CI, -1.0 to 0.06 percentage point]; P ?= 0.084). Participation in BPCI was also associated with differences in decreases in postacute spending and discharge to institutional postacute care providers. Decreases in episode spending were larger for hospitals with high baseline spending but did not vary by MA status. Nonrandomized studies are subject to residual confounding and selection. Participation in BPCI was associated with modest spillovers in episode savings. Bundled payments may prompt hospitals to implement broad care redesign that produces benefits regardless of insurance coverage. Leonard Davis Institute of Health Economics at the University of Pennsylvania.
机译：None

著录项

  • 来源
    《Annals of Internal Medicine》 |2021年第2期|共9页
  • 作者

    Amol S Navathe; Joshua M Liao; Kristin A Linn; Yi Zhang; Akriti Mishra; Robin Wang; Claire T Dinh; Jingsan Zhu; Deborah S Cousins; Jacob Lindner; Ezekiel J Emanuel;

  • 作者单位

    Corporal Michael J. Crescenz VA Medical Center and Perelman School of Medicine and Leonard Davis;

    University of Washington School of Medicine;

    Perelman School of Medicine University of Pennsylvania;

    Perelman School of Medicine University of Pennsylvania;

    Perelman School of Medicine University of Pennsylvania;

    Perelman School of Medicine University of Pennsylvania;

    Perelman School of Medicine University of Pennsylvania;

    Perelman School of Medicine and Leonard Davis Institute of Health Economics University of;

    Perelman School of Medicine University of Pennsylvania;

    Perelman School of Medicine University of Pennsylvania;

    Perelman School of Medicine and Leonard Davis Institute of Health Economics University of;

  • 收录信息
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 内科学;
  • 关键词

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号