Bundled Pay Management Statistics 2024 – Everything You Need to Know

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Best Bundled Pay Management Statistics

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Bundled Pay Management Market Statistics

  • In 2011, compared with non BPCI markets, BPCI markets were larger in total population, had a lower percentage of individuals on a low income, higher Medicare Advantage penetration, and more skilled nursing facility beds. [0]
  • Market level Accountable Care Organization penetration increased differentially by 3 percentage points for BPCI markets compared with non BPCI markets from the same baseline penetration of 7%. [0]
  • The Medicare Advantage population differentially increased by 0.5 percentage points in BPCI markets. [0]
  • Values are numbers unless stated otherwise BPCI hospitals differed from non BPCI hospitals in hospital, market, and episode characteristics in 2011 at the beginning of the baseline period. [0]

Bundled Pay Management Latest Statistics

  • The differential reduction was driven largely by a 5.9% relative decrease in the percentage of episodes in which patients were discharged to post. [1]
  • The CJR program did not have a significant differential effect on the composite rate of complications or on the percentage of jointreplacement procedures performed in high. [1]
  • Since BPCIA started, the medical care for HPMC’s patients has cost 15% less than the targets set by CMS. [2]
  • For instance, HPMC has reduced its 90day postdischarge mortality rate for patients in those seven bundles by nine percentage points and its 90 day readmission rate for them by five percentage points. [2]
  • After it identified likely BPCIA patients, the CCT then followed them through 90 days after discharge from HPMC. [2]
  • The differential reduction was driven largely by a 5.9% relative decrease in the percentage of episodes in which patients were discharged to post–acute care facilities. [3]
  • The CJR program did not have a significant differential effect on the composite rate of complications or on the percentage of jointreplacement procedures performed in high. [3]
  • Medicare categorized the 196 eligible areas into strata according to the median population. [3]
  • Risk scores were estimated with the use of a linear regression model predicting total spending for each episode fitted with data incorporating patient characteristics from 2013 through 2014 . [3]
  • Using claims from a 20% random sample of beneficiaries, we measured total Medicare spending per hipor knee. [3]
  • Utilization measures included the use of post–acute care services according to facility type, length of stay in post–acute care facilities, and readmission or visits to an emergency department within 90 days after discharge. [3]
  • We provide 95% confidence intervals, without P values, for exploratory estimates of secondary outcomes, which were not adjusted for multiple testing. [3]
  • In the treatment areas, 7% of the procedures were performed in the 8 areas that were excluded after randomization. [3]
  • The percentage of patients in the highest quartile of risk was not adjusted for characteristics of the patients and episodes because these characteristics are used to generate the patient risk score, which uses coefficients estimated from 2013–2014 data. [3]
  • The CJR program did not have a significant differential effect on the composite rate of complications (adjusted differential change in the percentage of episodes associated with a complication, βˆ’0.04%; P=0.67). [3]
  • In sensitivity analyses excluding admissions for hip fracture, results were similar (adjusted differential change in the percentage of episodes associated with a complication, βˆ’0.05%; 95% CI, βˆ’0.2 to 0.1). [3]
  • In treatment areas, there was a differential decrease in the percentage of patients who originally enrolled in Medicare because of disability (βˆ’0.6 percentage points; 95% CI, βˆ’1.0 to βˆ’0.2; or relative change of βˆ’3.8%). [3]
  • However, the estimated effect of the CJR program on spending per episode was reduced by only 2.5% after adjustments for observed characteristics of the patients before accounting for characteristics of the episodes. [3]
  • The 3% reduction in payments was significantly offset by bonuses paid by Medicare to hospitals with spending below their CJR benchmark, although even after these payments, there was a small net savings.1,23. [3]
  • Percentages may not total 100 because of rounding. [3]
  • Data were missing for 0.16% of episodes that primarily occurred in Puerto Rico. [3]
  • The outcome of the top quartile of patient risk was not adjusted for characteristics of the patients and episodes because these characteristics were used to generate the patient risk score, which uses coefficients estimated from 2013–2014 data. [3]
  • According to the Medicare approach, each episode was classified as having no complications or one or more complications within 90 days after discharge following the index hospitalization. [3]
  • The 95% confidence intervals are not adjusted for multiple testing and should be interpreted with caution, since the analyses are exploratory. [3]
  • This spending estimate is based on a 20% random sample of hipor knee replacement episodes because data on spending for professional services were available only for 20% of the sample of Medicare beneficiaries. [3]
  • Quality Measure Performance Percentiles CJR Model PY 6. [4]
  • Among the 196 MSAs and 1633 hospitals, 131 285 eligible LEJR procedures were performed during the study period among 130 343 patients (mean age, 72.5 [SD, 0.91] years; 65% women; 90% white). [5]
  • The mean percentage of LEJR admissions discharged to institutional postacute care was 33.7% (SD, 11.2%) in the control group and was 2.9 percentage points lower (95% CI, βˆ’4.95 to βˆ’0.90 percentage points). [5]
  • Mean Medicare spending for institutional postacute care per LEJR episode was $3871 in the control group and was $307 lower (95% CI, βˆ’$587 to βˆ’$27). [5]
  • Mean overall Medicare spending per LEJR episode was $22 872 in the control group and was $453 lower (95% CI, βˆ’$909 to $3). [5]
  • By 2016, 30% of traditional Medicare reimbursement had been shifted from feefor service models to alternative payment models. [5]
  • In 2014, there were 486 249 LEJR procedures, accounting for $6.2 billion of Medicare inpatient spending (4.52% of all inpatient Medicare spending). [5]
  • LEJR episodes in eligible MSAs in 2016, we estimated that 75% of episodes would be covered by CJR if the MSA was selected for treatment; section 1 of eAppendix 1 and eTable 1 in Supplement 1 provide more detail on the eligibility criteria and this estimate. [5]
  • CMS set different treatment probabilities for MSAs by strata (ranging from 30% to 45%). [5]
  • at least 50% of LEJR episodes in the baseline period were non BPCI; and at least 50% of otherwise eligible LEJR episodes not in Maryland hospitals. [5]
  • Treatment probabilities varied within the payment quartiles 30% in the first quartile , 35% in the second, 40% in the third, and 45% in the fourth. [5]
  • In the first year, the stop gain was +5% and there was no downside risk; by the fifth year, the stop gain and stop loss were each scheduled to be 20% of the target price.19,20. [5]
  • We used Medicare FFS claims data for 100% of enrollees from 2012 2014 and 2016 in the 196 eligible MSAs. [5]
  • Based on historical data, we estimated the analysis to have power to detect a 2percentagepoint reduction in the primary outcome (2 sided Ξ± = .05 at 80% power). [5]
  • Assignment to CJR thus increased the chance of being included in CJR by 89.1 percentage points (95% CI, 81.8 96.4 percentage points; P < .001). [5]
  • On average, among eligible MSAs, the patient study population was 90% white and 65% female, with a mean age of 72.5 years and a mean Elixhauser Comorbidity Index of 2.4. [5]
  • Eligible hospitals had a mean of 289.1 beds and performed a mean of 20.4 CJReligible LEJR procedures per month over the study period ; 25.3% were for profit hospitals and 9.3% were teaching hospitals. [5]
  • For profit hospitals, %d25.3 25.0 Teaching hospitals, %. [5]
  • Mean Difference (95% CI). [5]
  • ValuecDischarge destination, % Institutional postacute cared41.0 βˆ’0.4 .51. [5]
  • βˆ’0.18 to 0.21).8990d Emergency department visits during episode, %20.1 0.56 .1590d All cause readmission rate, %i10.9. [5]
  • Mean Difference (95% CI) Between Bundled Payment and Control MSAsP ValuebDischarge destination, % Institutional postacute carec33.7 βˆ’2.9 . [5]
  • aChange with bundled payment was estimated with the use of 2stage least squares instrumental variable regression, with random assignment to CJR used as an instrument for inclusion in CJR. [5]
  • Medicare spending on institutional postacute care was $3871 in the control group and was $307 lower (95% CI, βˆ’$587 to βˆ’$27; P = .04). [5]
  • For example, the 90 day emergency department visit rate was 20.1% (SD, 2.9%) for the control group, and was 0.25 percentage points higher (95% CI, βˆ’0.44 to 0.93 percentage points; P = .48). [5]
  • Mean Difference (95% CI) Between Bundled Payment and Control MSAsP ValuebQuality measures Targeted measure composite quality scorec9.3 . [5]
  • 2.8)0.72 .1090 d Nontargeted quality measures, %Complication rate1.2. [5]
  • aChange with bundled payment was estimated with the use of 2 stage least squares instrumental variable regression with random assignment to CJR used as an instrument for inclusion in CJR. [5]
  • A differenceindifferences analysis of the associations of BPCI for LEJR found a 4% decline in Medicare spending; a pre post analysis of BPCI for LEJR in one health system found a 21% decline and received considerable attention in the media. [5]
  • Inpatient savings constituted 85–93 percent of total savings. [6]
  • Cromwell, Dayhoff, and Thoumaian also found that hospital costs declined during the period of the study; in three of the four hospitals, average total costs per case fell by 2–23 percent. [6]
  • The price of the bundle included the estimated cost of a typical hospitalization plus half of the average cost of post–acute care for the 90 day period following surgery. [6]
  • A small study that compared the 117 patients in the intervention with 137 patients from a year prior to the implementation found that hospital costs dropped by 5 percent. [6]
  • In the Geisinger Health System experience with bundled payment for coronary artery bypass graft surgery, hospital costs decreased by about 5 percent and 30 day readmission rates fell from 15.5 percent to 7 percent. [6]
  • Cromwell, Dayhoff, and Thoumaian found significant cost savings in three of the four participating hospitals, with costs declining between 2 and 23.4 percent per case, unadjusted for inflation. [6]
  • Average length of stay also declined in all four hospitals, by 14 to 32 percent. [6]
  • The price of the bundle included the estimated cost of a typical hospitalization, plus half of the average cost of post acute care for the 90 day period following surgery. [6]
  • found that the average length of stay decreased by 16 percent. [6]
  • At the beginning of the program, adherence to best practices was 59 percent; after the program began, performance rose steadily, reaching 100 percent at three months but then fell to 86 percent. [6]
  • Performance once again reached 100 percent at six months and stayed there for the remaining six months of the evaluation period. [6]
  • In a study evaluating the program, Cromwell, Dayhoff, and Thoumaian found that, after controlling for patient characteristics, heart bypass patients in the program had a one–half percentage point lower mortality than the national average. [6]
  • Remarkably, just two (6%). [7]
  • Among the 196 MSAs and 1633 hospitals, 131β€―285 eligible LEJR procedures were performed during the study period among 130β€―343 patients (mean age, 72.5 [SD, 0.91] years; 65% women; 90% white). [8]
  • The mean percentage of LEJR admissions discharged to institutional postacute care was 33.7% (SD, 11.2%) in the control group and was 2.9 percentage points lower (95% CI, βˆ’4.95 to βˆ’0.90 percentage points). [8]
  • Mean Medicare spending for institutional postacute care per LEJR episode was $3871 in the control group and was $307 lower (95% CI, βˆ’$587 to βˆ’$27). [8]
  • Mean overall Medicare spending per LEJR episode was $22β€―872 in the control group and was $453 lower (95% CI, βˆ’$909 to $3). [8]
  • By 2016, 30% of traditional Medicare reimbursement had been shifted from feefor service models to alternative payment models. [8]
  • In 2014, there were 486β€―249 LEJR procedures, accounting for $6.2 billion of Medicare inpatient spending (4.52% of all inpatient Medicare spending). [8]
  • LEJR episodes in eligible MSAs in 2016, we estimated that 75% of episodes would be covered by CJR if the MSA was selected for treatment; section 1 of eAppendix 1 and eTable 1 in Supplement 1 provide more detail on the eligibility criteria and this estimate. [8]
  • CMS set different treatment probabilities for MSAs by strata (ranging from 30% to 45%). [8]
  • In the first year, the stop gain was +5% and there was no downside risk; by the fifth year, the stop gain and stop loss were each scheduled to be 20% of the target price. [8]
  • We used Medicare FFS claims data for 100% of enrollees from 2012 2014 and 2016 in the 196 eligible MSAs. [8]
  • Based on historical data, we estimated the analysis to have power to detect a 2percentagepoint reduction in the primary outcome (2 sided α = .05 at 80% power). [8]
  • Assignment to CJR thus increased the chance of being included in CJR by 89.1 percentage points (95% CI, 81.8 96.4 percentage points; P < .001). [8]
  • On average, among eligible MSAs, the patient study population was 90% white and 65% female, with a mean age of 72.5 years and a mean Elixhauser Comorbidity Index of 2.4. [8]
  • Eligible hospitals had a mean of 289.1 beds and performed a mean of 20.4 CJReligible LEJR procedures per month over the study period ; 25.3% were for profit hospitals and 9.3% were teaching hospitals. [8]
  • Medicare spending on institutional postacute care was $3871 in the control group and was $307 lower (95% CI, βˆ’$587 to βˆ’$27; P = .04). [8]
  • Excluding reconciliation payments, total Medicare spending per LEJR episode was $453 lower . [8]
  • P = .06) in the CJR group, and inclusive of reconciliation payments, total Medicare spending per LEJR episode was $234 higher . [8]
  • For example, the 90 day emergency department visit rate was 20.1% (SD, 2.9%) for the control group, and was 0.25 percentage points higher (95% CI, βˆ’0.44 to 0.93 percentage points; P = .48). [8]
  • A differenceindifferences analysis of the associations of BPCI for LEJR found a 4% decline in Medicare spending ; a pre post analysis of BPCI for LEJR in one health system found a 21% decline and received considerable attention in the media. [8]
  • In addition, a matched control study of Medicare’s Heart Bypass Center Demonstration Project estimated net savings of 14% per episode and was cited as reason to expect substantial savings from subsequent bundled payment programs. [8]
  • In the adjusted analysis, participation in BPCI was associated with a decrease in total episode spending (βˆ’1.2%, 95% confidence interval βˆ’2.3% to βˆ’0.2%). [0]
  • Spending on care at skilled nursing facilities decreased (βˆ’6.3%, βˆ’10.0% to βˆ’2.5%) owing to a reduced number of facility days (βˆ’6.2%, βˆ’9.8% to βˆ’2.6%), and home health spending increased (4.4%, 1.4% to 7.5%). [0]
  • Mortality at 90 days did not change (βˆ’0.1 percentage points, 95% confidence interval βˆ’0.5 to 0.2 percentage points). [0]
  • Most bundled payment evaluations have focused on surgical episodes, with hospitals participating in hip and knee joint replacement bundles showing about 4% episode savings without changes in quality, volume, or case mix.111213. [0]
  • Although BPCI allowed participants to select from a post hospital admission episode duration of 30, 60, or 90 days, we used the 90 day duration because more than 96% of participants selected it. [0]
  • Further, mortality is not uncommon in patients admitted to hospital for the four medical conditions evaluated . [0]
  • We used an adjusted Ξ± of 0.025 according to the Bonferroni method for the two primary outcomes and 0.05 for secondary outcomes.42. [0]
  • We also examined for any residual correlation between errors across groups after clustering standard errors, possibly because of the 20% sample for non. [0]
  • The smaller number of nonBPCI episodes was related to the 20% sample for the non. [0]
  • At baseline, 44.4% of patients at BPCI hospitals and 44.5% at non BPCI hospitals were men, with a differential change of βˆ’0.01 percentage points. [0]
  • Patient Elixhauser comorbidity index scores for BPCI hospitals increased from 19.4 in the baseline period to 19.5 in the treatment period, whereas it increased from 19.4 to 19.6 for non. [0]
  • Values are numbers unless stated otherwiseRisk adjusted changes in spending associated with hospital participation in bundled payments for care improvement for four medical conditions, 2011. [0]
  • differenceSecondary outcomesIn adjusted differencein differences analyses, spending on skilled nursing decreased . [0]
  • % to βˆ’2.5%) in favor of increased spending on home health services (4.4%, 1.4% to 7.5%; fig 1). [0]
  • A decrease also occurred in outpatient professional fees (βˆ’10.4%, βˆ’19.5% to βˆ’0.3%).Among secondary use outcomes, BPCI participation was associated with a differential decrease in total skilled nursing days during the episode (βˆ’6.2%, βˆ’9.8% to βˆ’2.6%). [0]
  • Sensitivity analysesThe drop out rate across all conditions was 31.6%. [0]
  • The decrease in total spending for hospitals that remained in the programme of βˆ’1.8% (95% confidence interval βˆ’2.6 to βˆ’1.0). [0]
  • However, there were also increases in spending on readmissions (3.6%, 0.9% to 6.3%) and the 90 day readmission rate (1.4 percentage points, 95% confidence interval 0.9 to 2.0 percentage points; appendix figure 8). [0]
  • Mortality at 90 days did not change (βˆ’0.1 percentage points, 95% confidence interval βˆ’0.5 to 0.2 percentage points). [0]
  • Further, mortality is not uncommon in patients admitted to hospital for the four medical conditions evaluated (eg, 12.5% in the study baseline period). [0]
  • In adjusted differencein differences analysis , BPCI participation was associated with a differential decrease in total episode spending of 1.2% (95% confidence interval βˆ’2.3% to βˆ’0.2%). [0]
  • Values are numbers unless stated otherwise Risk adjusted changes in spending associated with hospital participation in bundled payments for care improvement for four medical conditions, 2011. [0]
  • Unadjusted 90 day mortality decreased from 12.5% in the BPCI group in the baseline period to 12.0% in the treatment period, whereas mortality in the non BPCI group increased from 11.2% to 11.4%. [0]
  • In adjusted analysis, BPCI participation was not associated with a change in 90 day mortality (βˆ’0.1 percentage points, 95% confidence interval βˆ’0.5 to 0.2 percentage points; fig 2). [0]
  • In adjusted differencein differences analyses, spending on skilled nursing decreased . [0]
  • A decrease also occurred in outpatient professional fees (βˆ’10.4%, βˆ’19.5% to βˆ’0.3%). [0]
  • Among secondary use outcomes, BPCI participation was associated with a differential decrease in total skilled nursing days during the episode (βˆ’6.2%, βˆ’9.8% to βˆ’2.6%). [0]
  • Hospital participation in BPCI was associated with a differential decrease in total episode spending for pneumonia (βˆ’2.0%, 95% confidence interval βˆ’3.2% to βˆ’0.8%; appendix figure 4). [0]
  • The drop out rate across all conditions was 31.6%. [0]
  • The most recent numbers show that over 35% of US healthcare reimbursements flowed through APMsβ€”a 52% increase from three years earlier. [9]
  • Although CMS’s original intention was to begin the program in the first half of 2020, it is likely to be delayed due to stakeholder pushback. [9]
  • In fact, nearly 50% of patients relapse in their first year after discharge. [9]
  • In 2014, Medicare paid for nearly 500,000 hip and knee replacements, accounting for roughly $6 billion in Medicare inpatient spending. [10]
  • The population of Medicare beneficiaries in the study had an average age of 72.5 and was 90 percent white and 65 percent female. [10]
  • In the first year, hospitals spending below the target received a payment of up to 5 percent of the target but faced no penalty if they spent over the target. [10]
  • By the fifth year, however, it was planned that hospitals could lose or gain up to 20 percent of the target price depending on their spending and quality. [10]
  • Spending in institutional post acute care during the episode also declined by $307 per episode relative to a control group average of $3,871. [10]
  • The CJR bundled payment model decreased total Medicare spending per episode by $453 relative to a control group average of $22,872 , a result that was significant at the 10 percent level. [10]
  • CMS reported a six percent increase in the use of alternative payment models in 2016. [11]
  • Twenty nine percent of healthcare payments made in 2016 were under a bundled payment model, shared savings payment model, or a similar alternative payment model. [11]
  • DRIVE found that bundled payment amounts were 10 to 12 percent lower than feefor service amounts for certain surgical procedures. [11]
  • In 2016, healthcare costs jumped to $3.3 trillion dollars and healthcare spending is expected to grow by 5.4 percent per year from 2016 to 2028. [11]

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Reference


  1. bmj – https://www.bmj.com/content/369/bmj.m1780.
  2. nih – https://pubmed.ncbi.nlm.nih.gov/30601709/.
  3. hbr – https://hbr.org/2021/03/how-one-hospital-has-succeeded-in-a-world-of-bundled-payments.
  4. nejm – https://www.nejm.org/doi/full/10.1056/nejmsa1809010.
  5. cms – https://innovation.cms.gov/innovation-models/cjr.
  6. nih – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6142993/.
  7. rand – https://www.rand.org/pubs/technical_reports/TR562z20/analysis-of-bundled-payment.html.
  8. commonwealthfund – https://www.commonwealthfund.org/publications/2020/apr/bundled-payment-models-around-world-how-they-work-their-impact.
  9. jamanetwork – https://jamanetwork.com/journals/jama/fullarticle/2698927.
  10. ecgmc – https://www.ecgmc.com/thought-leadership/blog/bundled-payments-the-outlook-for-2020.
  11. povertyactionlab – https://www.povertyactionlab.org/evaluation/impact-bundled-payments-medicare-spending-utilization-and-quality-united-states.
  12. healthpayerintelligence – https://healthpayerintelligence.com/news/why-bundled-payments-are-a-popular-option-for-healthcare-payers.

How Useful is Bundled Pay Management

One key advantage of bundled pay management is its ability to simplify complex billing processes. Instead of parceling out each individual service or product separately, businesses can combine them into one easy-to-understand package for customers. This not only reduces confusion and potential errors in invoicing but also saves time and effort on the part of both the business and the consumer. Moreover, bundled pay management can lead to cost savings for the customer, as bundled packages often come at a lower price compared to purchasing each item separately.

Another benefit of bundled pay management is its potential to enhance customer loyalty and satisfaction. By offering bundled packages that cater to the specific needs and preferences of customers, businesses can create a more personalized experience that resonates with their target audience. This can increase customer retention and loyalty, as well as generate positive word-of-mouth referrals, ultimately driving sales and revenue growth for the business.

Furthermore, bundled pay management can foster stronger partnerships and collaborations between businesses and their suppliers or partners. By consolidating services or products into bundled packages, businesses can coordinate more effectively with their vendors to ensure seamless delivery and fulfillment. This can lead to improved supply chain management, reduced inventory costs, and increased overall operational efficiency. In addition, bundled pay management can help businesses negotiate better pricing and terms with their suppliers, leading to cost savings that can be passed on to the customer.

Despite these potential benefits, bundled pay management may not be suitable for every business or industry. One potential drawback is the lack of flexibility in bundled packages, as customers may not always want or need every service or product included in the bundle. This can result in a loss of revenue or customer dissatisfaction if customers are forced to pay for services they do not use or want. Additionally, businesses must carefully consider the pricing and value proposition of their bundled packages to ensure that they are competitive and attractive to customers.

In conclusion, the usefulness of bundled pay management ultimately depends on the specific needs, objectives, and dynamics of each business. While it can offer significant benefits in terms of simplifying billing processes, enhancing customer loyalty, and streamlining supplier relationships, businesses must carefully evaluate whether bundled pay management is the right approach for their unique circumstances. By balancing the advantages and potential limitations of bundled pay management, businesses can maximize its effectiveness and ultimately drive success in today’s competitive marketplace.

In Conclusion

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