RESUMO
The Bundled Payments for Care Improvement Advanced Model (BPCI-A), a voluntary Alternative Payment Model for Medicare, incentivizes hospitals and physician group practices to reduce spending for patient care episodes below preset target prices. The experience of physician groups in BPCI-A is not well understood. We found that physician groups earned $421 million in incentive payments during BPCI-A's first four performance periods (2018-20). Target prices were positively associated with bonuses, with a mean reconciliation payment of $139 per episode in the lowest decile of target prices and $2,775 in the highest decile. In the first year of the COVID-19 pandemic, mean bonuses increased from $815 per episode to $2,736 per episode. These findings suggest that further policy changes, such as improving target price accuracy and refining participation rules, will be important as the Centers for Medicare and Medicaid Services continues to expand BPCI-A and develop other bundled payment models.
Assuntos
COVID-19 , Prática de Grupo , Medicare , Pacotes de Assistência ao Paciente , Estados Unidos , Humanos , Medicare/economia , Pacotes de Assistência ao Paciente/economia , Prática de Grupo/economia , COVID-19/economia , Reembolso de Incentivo/economia , Mecanismo de Reembolso , SARS-CoV-2 , Gastos em Saúde/estatística & dados numéricosRESUMO
This cross-sectional study examines how changes in privately insured families' contributions to insurance premiums and out-of-pocket spending have affected the financial burden of health care in recent decades.