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Bundled Payment Initiative Had No Effect on COPD Readmissions

Last Updated: December 30, 2016.

Implementation of the Medicare Bundled Payments for Care Improvement initiative has failed to cut readmission rates following hospitalization for acute exacerbation of chronic obstructive pulmonary disease, according to a study published online Dec. 22 in the Annals of the American Thoracic Society.

FRIDAY, Dec. 30, 2016 (HealthDay News) -- Implementation of the Medicare Bundled Payments for Care Improvement (BPCI) initiative has failed to cut readmission rates following hospitalization for acute exacerbation of chronic obstructive pulmonary disease (COPD), according to a study published online Dec. 22 in the Annals of the American Thoracic Society.

Surya P. Bhatt, M.D., from University of Alabama at Birmingham, and colleagues compared all-cause readmissions and costs following index hospitalization for consecutive Medicare-only patients with acute exacerbation of COPD before (109 patients in 2012) and after (78 patients in 2014) implementation of a comprehensive, multidisciplinary intervention focusing on inpatient, transitional, and outpatient care as participation in a BPCI initiative.

The researchers found that patients in BPCI were more likely to receive regular follow-up phone calls, pneumococcal and influenza vaccines, home health care, durable medical equipment, pulmonary rehabilitation, and to attend pulmonary clinic. However, there was no difference in all-cause readmission rates at 30 days (BPCI, 15.4 percent; non-BPCI, 17.4 percent; P = 0.711), and 90 days (26.9 versus 33.9 percent; P = 0.306). Before accounting for significant investment from the health system, 90-day costs were 4.3 percent lower, compared to BPCI target prices.

"A Medicare BPCI intervention did not reduce 30-day all-cause readmission rates or overall costs following hospitalization for acute exacerbation of COPD," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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