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Commercial Bundles

With premiums on the rise and commercial payers interested in increasing the value return on their healthcare investment, more payers are considering value-based care arrangements.

While CMS has led the charge to use bundled payments for joint replacements through the Bundled Payments for Care Improvement (BPCI) and Comprehensive Care for Joint Replacement (CJR) program, there is increasing interest in these arrangements from the payer market.

As payers and providers begin to anticipate and plan for the change, it’s important to study bundled payments from a variety of angles looking at cost variations by region, market, provider type, and payers.

Hospital Performance

April 2017

Winners of the Truven Health Analytics™ 100 Top Hospitals® designation demonstrate how effective leaders manage change and achieve excellence in a dynamic environment. Using the measures presented in our National Balanced Scorecard, this year’s 100 Top Hospitals® study revealed significant differences between award winners and their nonwinning peers.

The nation’s top-performing hospitals had lower inpatient mortality, considering patient severity; had fewer patient complications; followed accepted care protocols for stroke care and blood clot prevention; had lower 30-day mortality and 30-day readmission rates; sent patients home sooner; provided more timely emergency care; kept expenses lower, both in-hospital and through the aftercare process; and scored 10 points higher on patient ratings of their overall hospital experience.

Mental Health and Substance Abuse Treatment Trends

March 2017

Behavioral health and substance abuse treatment costs are rising, along with demand for these services, driven in part by the opioid abuse epidemic. The Substance Abuse and Mental Health Services Administration projects that by 2020, mental health and substance abuse (MHSA) treatment spending will total $280.5 billion, a 63% increase from 2009.* Increasing utilization of substance abuse services reveals an opportunity to expand treatment and prevention programs in-house or through partnerships. In addition, hospitals and health systems can respond to these rising costs and greater need by ensuring opioid prescribing patterns meet current guidelines and by instituting care management assistance when pain medications are necessary.

 

30-Day Readmission Rates

February 2017

The Truven Health Analytics study of 30-day readmission rates uses Medicare Hospital Compare data to analyze differences in readmission rates among hospitals across the nation. Aggressive efforts are being made by the Centers for Medicare & Medicaid Services, private health plans, and providers to reduce unplanned hospital readmissions. This study examines 30-day hospital readmission rates from 2011 to 2015. Rates of 30-day unplanned readmissions have improved consistently during the five-year period.

 

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