Bundled Payments for Care Improvement (BPCI) linked to declining Medicare payments for lower-extremity joint replacement

New research featured in the Journal of the American Medical Association

In 2013, the Centers for Medicare & Medicaid Services (CMS) launched the Bundled Payments for Care Improvement (BPCI) initiative to see whether linking payments for services provided during an episode of care can reduce Medicare payments, while maintaining or improving quality. The BPCI initiative holds participating hospitals and other entities accountable for Medicare payments for services provided during an episode of care triggered by a hospitalization. This initiative is designed to reward clinicians and facilities that deliver care in more efficient and effective ways.

In a recent study, using data from 2011 to 2015, researchers asked the question, “Is there an association between the Bundled Payments for Care Initiative (BPCI) and Medicare payments and quality of care for lower-extremity joint replacement episodes?” Findings showed that the BPCI initiative was associated with a greater reduction in Medicare per-episode payments, with no decline in care quality, when compared to hospitals not participating in BPCI.

While further research is needed, the report in the Journal of the American Medical Association concludes that “bundled payments for lower-extremity joint replacement episodes may have the potential to decrease Medicare per-episode payments, while maintaining quality of care.”

Read the whole report, “Association Between Hospital Participation in a Medicare Bundled Payment Initiative and Payments and Quality Outcomes for Lower Extremity Joint Replacement Episodes,”  published online September 19, 2016.