Graduation Year

2018

Document Type

Dissertation

Degree

D.B.A.

Degree Granting Department

Business

Major Professor

Anol Bhattacherjee, Ph.D.

Co-Major Professor

Kaushik Dutta, Ph.D.

Committee Member

Shivendu Shivendu, Ph.D.

Committee Member

Jay Wolfson, Ph.D.

Keywords

healthcare, value based reimbursement, pay for performance, BPCI, hospital finance

Abstract

In 2013, Medicare launched the Bundled Payments for Care Improvement (BPCI) Initiative which linked payments for multiple services for a complete episode of patient care. With this innovative reimbursement model, hospitals accepted fixed target payments for certain types of clinical diagnoses that were intended to support better care coordination and better outcomes for patients at lower cost to Medicare. This was one of many programs aimed at addressing the serious challenges facing United States healthcare, including costs that are skyrocketing to unsustainable levels and lack of coordination of care across venues.

Preliminary Medicare results showed that bundled payments might lead to lower costs and higher quality of care, however, this idea comes from a relatively small sample size and limited run time of the program. This study examined one large community hospital in the southeast part of the United States participating in the BPCI Initiative. Patient level data was retrospectively analyzed using statistical techniques to determine if financial, operational and clinical outcomes improved as result of the BPCI program compared to similar patient data before the program.

The results were mixed. Financial outcomes did not change significantly, and remained higher than the CMS targets. Length of stay decreased significantly, as anticipated. The 30-day readmissions was statistically unchanged. This study illuminated both challenges and strategies in implementing bundled payments to achieve positive financial, operational, and clinical outcomes.

Download

Share

COinS