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Analysis

Researchers Fire Bundled-Payments Warning Shots

By Christopher Cheney  
   September 26, 2016

Regulators should guard against unintended consequences linked to bundled payments and post-acute-care providers should brace for revolutionary change, says the chief of The Dartmouth Institute for Health Policy.

Bundled payments research published last week fires a double-barreled shot across the bows of federal policymakers and post-acute-care providers, the author of an editorial accompanying the research says.

In the Journal of the American Medical Association study, lead author Laura Dummit, MSPH, and 13 other researchers examined hip and knee joint replacement data from the Bundled Payments for Care Improvement (BPCI) initiative, Medicare's largest bundled-payments voluntary demonstration program.


Behind Bundled Payments, Unintended Consequences Lurk


Although the researchers found that reduced skilled nursing facility utilization among BPCI-participating hospitals cut episode-of-care spending without sacrificing quality, the data also indicates significant risk of negative unintended consequences, says Elliott Fisher, MD, MPH.

Fisher was interviewed by HealthLeaders Media last week.

The BPCI research, which included a control group of 841 nonparticipating hospitals, can be interpreted from polar opposite perspectives, according to Fisher, director of The Dartmouth Institute for Health Policy and Clinical Practice, in Lebanon, NH, and a professor at Dartmouth College's Geisel School of Medicine in Hanover, NH.

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


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