Health Affairs November, 2022
Karen E. Joynt Maddox, E. John Orav, Jie Zheng, and Arnold M. Epstein

Abstract

Medicare’s Bundled Payments for Care Improvement Advanced Model (BPCI-A) is a voluntary Alternative Payment Model in which participating hospitals are held accountable for ninety-day episodes of care. To meet spending targets, hospitals must either decrease utilization or attract a less sick patient population; this could lead to the elimination of necessary care or avoidance of patients with medical or social vulnerability. We used publicly available data on BPCI-A participation, along with Medicare claims from the period 2017–19, to examine patient selection,...

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Topics: Bundled Payments, CMS, Govt Agencies, Insurance, Medicare, Payment Models, Provider, Value Based
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