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Mixed results from CMS’s orthopedic bundle initiative


The CMS has released its second annual evaluation for Models 2-4 of the Bundled Payments for Care Improvement (BPCI) initiative, which details the results from the first year of the initiative, which, for now, involves orthopedic surgery.

Patrick Conway, M.D., CMS’s acting principal deputy administrator and chief medical officer, called the results for orthopedic-surgery bundles encouraging, noting that under Model 2, participating hospitals were shown to have achieved statistically significant savings of $864 per episode while improving quality.

To read Dr. Conway’s remarks, please hit this link.

But, the report also showed that average payments for spinal-surgery episodes rose $3,477 more compared to the increase among nonbundling providers.

HealthcareDIVE commented:

“While the report stresses additional future analyses will be required to estimate any overall savings impact to Medicare, the CMS highlighted its optimism that 11 out of the 15 clinical episode groups that were analyzed did show indicators for potential savings.

“As more data become available over the next year and beyond, upcoming reports will be able to better estimate the BPCI initiative’s impacts on both costs and quality. This report, prepared by The Lewin Group, was the second of five planned annual reports. It looked at the experiences of Phase 2 participants in the first year of the initiative, in which episodes were initiated between October 2013 and September 2014. The report’s qualitative results reflect participants’ experiences through June 2015, the researchers said, noting that participation has continued to grow since, with more providers entering Phase 2 in April and July 2015.’’

To read the HealthcareDIVE analysis, please hit this link.

Meanwhile, CMS is moving ahead developing  additional bundled-payment models. Hit this link to look at one such model — cardiology. 

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