The Bundled Payments for Care Improvement (BPCI) model is associated with a decrease in institutional spending on lower extremity joint replacement episodes initiated by admission to skilled nursing facilities, according to results from a recent study (JAMA. 2020;324[18]:1869-1877. doi:10.1001/jama.2020.19181).
“Medicare recently concluded a national voluntary payment demonstration, BPCI model 3, in which skilled nursing facilities assumed accountability for patients’ Medicare spending for 90 days from initial [skilled nursing facility] admission,” explained Michael Barnett, MD, MS, Harvard T.H. Chan School of Public Health and Brigham and Women’s Hospital, Boston, Massachusetts and colleagues.
Researchers used an observational difference-in-difference analysis using Medicare claims from 2013-2017 to evaluate the association of the BCPI model 3 with spending, health care utilization, and patient outcomes for Medicare beneficiaries undergoing lower extremity joint replacement.
Institutional spending decreased 5.6% in BCPI skilled nursing facilities and in matched controls (P <.001). skilled nursing facility days per beneficiary in BCPI skilled nursing facilities were decreased from 26.2 to 21.3 days and from 26.3 to 23.4 days in matched controls for a differential change of -2.0 days.
“Among Medicare patients undergoing lower extremity joint replacement from 2013-2017, the BPCI model 3 was significantly associated with a decrease in mean institutional spending on episodes initiated by admission to [skilled nursing facilities],” concluded Dr Barnett and colleagues.—Lisa Kuhns
