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New Study: Medicare Bundled Payment Initiative Maintained Patient Health Outcomes

Rockville, Md. – One of the key goals of the Centers for Medicare & Medicaid Services (CMS) has been to reduce health care costs while maintaining or improving patient outcomes. Research led by Abt Global, in partnership with the Lewin Group, finds that physician group practices participating in CMS’s Bundled Payment for Care Improvement (BPCI) initiative did not deliver diminished patient-reported health outcomes. This builds on previous research that found practices participating in BPCI were, in fact, able to reduce the cost of care.

CMS designed the BPCI initiative to reward providers who delivered care more efficiently to Medicare beneficiaries, while preserving or enhancing the quality of care. A major question has been whether the program’s incentives may cause providers to reduce beneficial care, adversely affecting patient outcomes. Abt’s latest study of bundled payment episodes offers promising insights. The findings, published in the Journal of General Internal Medicine, are particularly significant, because the study is one of the first to focus on treatment managed by physician practices (as opposed to hospitals), drawing on over 30,000 survey responses from Medicare beneficiaries.

For this study, Abt researchers surveyed Medicare beneficiaries who were recently hospitalized for conditions such as sepsis, heart failure, and hip and knee replacements. While slightly fewer BPCI patients in this survey reported positive care experiences in three of eight outcomes (relative to those in a matched comparison group), there was no difference between the groups in terms of self-reported functional outcomes. Patients treated by BPCI physicians were just as successful at regaining or improving their mobility and other essential activities of daily living as their counterparts who were not treated by BPCI physicians.

“Patients whose physicians participated in BPCI reported the same degree of recovery a few months later, and rated their care just as highly, as those whose physicians did not participate,” said Abt’s lead author Sean McClellan, Ph.D. “This is reassuring evidence that reducing costs did not jeopardize patient care experiences or their post-hospital recovery.” 

While the BPCI initiative ended in 2018, this study has implications for other ongoing initiatives that use similar approaches to incentivize reductions in health care spending, including CMS’s BPCI Advanced Model and its Comprehensive Care for Joint Replacement Model, which were both based on BPCI.

Read the journal article.

Learn more about Abt’s work on BPCI.

About Abt Global
Abt Global is a global consulting and research firm that uses data and bold thinking to improve the quality of people’s lives. From combatting infectious disease and conducting rigorous program evaluations, to ensuring safe drinking water and promoting access to affordable housing—and more—we partner with clients and communities to tackle their most complex challenges.

Eric Tischler
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