Changes in Cardiovascular Spending, Care Utilization, and Clinical Outcomes Associated With Participation in Bundled Payments for Care Improvement – Advanced
Main finding · Differential change in spending, before vs after BPCI-A implementationResult — go to the resultDifferential change 16 $ 95% CI -$228 to $261Authors' conclusion
Participation in BPCI-A was not associated with spending reductions, changes in care utilization, or quality improvements for the cardiovascular medical events or procedures offered in the model.
Study context
- Population
- Medicare patients discharged after cardiac medical or procedural episodes, January 1, 2017–September 30, 2019
- Exposure
- Bundled Payments for Care Improvement - Advanced (BPCI-A) hospitals vs matched nonparticipating control hospitals
- Outcome
- Differential change in spending, before vs after BPCI-A implementation, for cardiac medical and procedural conditions
- Follow-up
- Episodes ending 90 days after discharge
Methodological detailsdifference-in-differences analyses, matched nonparticipating control hospitals
- Difference-in-differences analyses
- Matched nonparticipating control hospitals
Main finding
As reported in the abstract
Differential change in spending, before vs after BPCI-A implementation
Differential change
16 $
95% CI -$228 to $261
P = 0.90
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Differential change (95% CI) | |
|---|---|---|
| Readmissions · 90 daysBPCI-Avs ControlMedical episodes · no significant differential changes | 0.27% (−0.25% to 0.80%) | |
| Readmissions · 90 daysBPCI-Avs ControlProcedural episodes · no significant differential changes | 0.31% (−0.98% to 1.60%) | |
| MortalityBPCI-Avs ControlMedical episodes · no significant differential changes | −0.14% (−0.50% to 0.23%) | |
| MortalityBPCI-Avs ControlProcedural episodes · no significant differential changes | −0.36% (−1.25% to 0.54%) | |
| −2−1012Difference (linear scale) |
Patient complexity and care utilization
- Minimal differential changes in complexity of treated patients or care utilization
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Changes in Cardiovascular Spending, Care Utilization, and Clinical Outcomes Associated With Participation in Bundled Payments for Care Improvement – Advanced. Circulation. Published 8 September 2023. doi:10.
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