Early Results of Medicare's Bundled Payment Initiative for a 90-Day Total Joint Arthroplasty Episode of Care
Early Results of Medicare's Bundled Payment Initiative for a 90-Day Total Joint Arthroplasty Episode of Care
复制标题
DOI：
10.1016/j.arth.2015.09.004
复制
发表时间：
2016-02-01
影响因子：
3.5
通讯作者：
Zuckerman, Joseph D.
中科院分区：
文献类型：
--
作者：
Iorio, Richard;Clair, Andrew J.;Zuckerman, Joseph D.
背景：2011 年，Medicare 启动了护理改善捆绑支付 (BPCI) 计划，目标是引入一种支付模式，“以更低的 Medicare 成本提供更高质量、更协调的护理。”方法：在一家大型三级城市学术医疗中心实施了全关节置换术 (TJR) 的模型 2 捆绑支付计划。护理期间包括出院后 90 天内的所有费用。一年后，721 名 Medicare 初级 TJR 患者的数据可供分析。结果：平均住院时间 (LOS) 从 4.27 天减少到 3.58 天（中位 LOS 3 天）。住院治疗的出院率从 71% 下降到 44%。 80 名患者（11%）再次入院，略低于实施前。该医院的住院部分成本较基线有所下降。结论：该医疗中心实施 Medicare BPCI 模型 2 主要 TJR 计划的早期结果表明可以节省成本。
Background: In 2011 Medicare initiated a Bundled Payment for Care Improvement (BPCI) program with the goal of introducing a payment model that would "lead to higher quality, more coordinated care at a lower cost to Medicare."Methods: A Model 2 bundled payment initiative for Total Joint Replacement (TJR) was implemented at a large, tertiary, urban academic medical center. The episode of care includes all costs through 90 days following discharge. After one year, data on 721 Medicare primary TJR patients were available for analysis.Results: Average length of stay (LOS) was decreased from 4.27 days to 3.58 days (Median LOS 3 days). Discharges to inpatient facilities decreased from 71% to 44%. Readmissions occurred in 80 patients (11%), which is slightly lower than before implementation. The hospital has seen cost reduction in the inpatient component over baseline.Conclusion: Early results from the implementation of a Medicare BPCI Model 2 primary TJR program at this medical center demonstrate cost-savings.