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Medicare’s Bundled Payment Initiative: Most Hospitals Are Focused On A Few High-Volume Conditions.

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  • Additional Information
    • Subject Terms:
    • NAICS/Industry Codes:
      624120 Services for the Elderly and Persons with Disabilities
      621610 Home Health Care Services
      621390 Offices of all other health practitioners
      621399 Offices of All Other Miscellaneous Health Practitioners
      923130 Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs)
      622210 Psychiatric and Substance Abuse Hospitals
      624190 Other Individual and Family Services
      623220 Residential Mental Health and Substance Abuse Facilities
    • Abstract:
      The Bundled Payments for Care Improvement initiative is a federally funded innovation model mandated by the Affordable Care Act. It is designed to help transition Medicare away from fee-for-service payments and toward bundling a single payment for an episode of acute care in a hospital and related postacute care in an appropriate setting. While results from the initiative will not be available for several years, current data can help provide critical early insights. However, little is known about the participating organizations and how they are focusing their efforts. We identified participating hospitals and used national Medicare claims data to assess their characteristics and previous spending patterns. These hospitals are mostly large, nonprofit, teaching hospitals in the Northeast, and they have selectively enrolled in the bundled payment initiative covering patient conditions with high clinical volumes. We found no significant differences in episode-based spending between participating and nonparticipating hospitals. Postacute care explains the largest variation in overall episode-based spending, signaling an opportunity to align incentives across providers. However, the focus on a few selected clinical conditions and the high degree of integration that already exists between enrolled hospitals and postacute care providers may limit the generalizability of bundled payment across the Medicare system. [ABSTRACT FROM AUTHOR]
    • Abstract:
      Copyright of Health Affairs is the property of Project HOPE/HEALTH AFFAIRS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
    • Author Affiliations:
      1research associate, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health
      2general surgery resident, Department of Surgery, Brigham and Women's Hospital
      3senior adviser, deputy assistant secretary for health policy, Office of the Assistant Secretary for Planning and Evaluation (ASPE), Department of Health and Human Services, Washington, D.C.
      4senior adviser, deputy assistant secretary for health policy, ASPE, Department of Health and Human Services
      5statistical programmer, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health
      6analyst, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health
      7associate professor, biostatistics, Harvard T.H. Chan School of Public Health
      8K.T. Li Professor, International Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
    • ISSN:
      0278-2715
    • Accession Number:
      10.1377/hlthaff.2014.0900
    • Accession Number:
      101427976
  • Citations
    • ABNT:
      TSAI, T. C. et al. Medicare’s Bundled Payment Initiative: Most Hospitals Are Focused On A Few High-Volume Conditions. Health Affairs, [s. l.], v. 34, n. 3, p. 370–380, 2015. DOI 10.1377/hlthaff.2014.0900. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=101427976&custid=s8280428. Acesso em: 8 ago. 2020.
    • AMA:
      Tsai TC, Joynt KE, Wild RC, Orav EJ, Jha AK. Medicare’s Bundled Payment Initiative: Most Hospitals Are Focused On A Few High-Volume Conditions. Health Affairs. 2015;34(3):370-380. doi:10.1377/hlthaff.2014.0900
    • APA:
      Tsai, T. C., Joynt, K. E., Wild, R. C., Orav, E. J., & Jha, A. K. (2015). Medicare’s Bundled Payment Initiative: Most Hospitals Are Focused On A Few High-Volume Conditions. Health Affairs, 34(3), 370–380. https://doi.org/10.1377/hlthaff.2014.0900
    • Chicago/Turabian: Author-Date:
      Tsai, Thomas C., Karen E. Joynt, Robert C. Wild, E. John Orav, and Ashish K. Jha. 2015. “Medicare’s Bundled Payment Initiative: Most Hospitals Are Focused On A Few High-Volume Conditions.” Health Affairs 34 (3): 370–80. doi:10.1377/hlthaff.2014.0900.
    • Harvard:
      Tsai, T. C. et al. (2015) ‘Medicare’s Bundled Payment Initiative: Most Hospitals Are Focused On A Few High-Volume Conditions’, Health Affairs, 34(3), pp. 370–380. doi: 10.1377/hlthaff.2014.0900.
    • Harvard: Australian:
      Tsai, TC, Joynt, KE, Wild, RC, Orav, EJ & Jha, AK 2015, ‘Medicare’s Bundled Payment Initiative: Most Hospitals Are Focused On A Few High-Volume Conditions’, Health Affairs, vol. 34, no. 3, pp. 370–380, viewed 8 August 2020, .
    • MLA:
      Tsai, Thomas C., et al. “Medicare’s Bundled Payment Initiative: Most Hospitals Are Focused On A Few High-Volume Conditions.” Health Affairs, vol. 34, no. 3, Mar. 2015, pp. 370–380. EBSCOhost, doi:10.1377/hlthaff.2014.0900.
    • Chicago/Turabian: Humanities:
      Tsai, Thomas C., Karen E. Joynt, Robert C. Wild, E. John Orav, and Ashish K. Jha. “Medicare’s Bundled Payment Initiative: Most Hospitals Are Focused On A Few High-Volume Conditions.” Health Affairs 34, no. 3 (March 2015): 370–80. doi:10.1377/hlthaff.2014.0900.
    • Vancouver/ICMJE:
      Tsai TC, Joynt KE, Wild RC, Orav EJ, Jha AK. Medicare’s Bundled Payment Initiative: Most Hospitals Are Focused On A Few High-Volume Conditions. Health Affairs [Internet]. 2015 Mar [cited 2020 Aug 8];34(3):370–80. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=101427976&custid=s8280428