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| http://dx.doi.org/10.2215/CJN.03540322 | DOI Listing |
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Medical and Surgical Episodes Among Hospital Participants in the Bundled Payments for Care Improvement-Advanced Program.
JAMA Netw Open
December 2024
Center for Advancing Health Services, Policy & Economics Research, Institute for Public Health, Washington University, St Louis, Missouri.
Importance: Hospital participation in the Bundled Payments for Care Improvement-Advanced (BPCI-A) initiative has been associated with modest savings and stable clinical outcomes overall, but it is unknown whether the program performs differently for medical and surgical or procedural (henceforth, surgical) episodes.
Objective: To assess the association of BPCI-A participation with Medicare spending and clinical outcomes for medical and surgical episodes.
Design, Setting, And Participants: This retrospective difference-in-differences cohort study utilized 100% Medicare fee-for-service inpatient claims for episodes initiated between January 1, 2017, and September 30, 2019, and included 90 days of follow-up.
Outliers of Total Shoulder Arthroplasty in the Bundled Payment Era.
J Shoulder Elbow Surg
December 2024
Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA. Electronic address:
Background: The Centers for Medicare & Medicaid Services (CMS) implemented the Bundled Payments for Care Improvement Advanced (BPCIA) Model that covers 90-day care episodes after select orthopedic procedures including anatomic or reverse ball-and-socket total shoulder arthroplasty (TSA/rTSA). This study investigated whether patients undergoing TSA/rTSA for non-degenerative processes incur higher costs than patients undergoing arthroplasty for degenerative processes.
Methods: A retrospective review was conducted of all patients at a single academic medical center enrolled in the BPCIA model for TSA/rTSA from October 1, 2018, through December 31, 2022.
Large Language Models for More Efficient Reporting of Hospital Quality Measures.
NEJM AI
October 2024
Division of Biomedical Informatics, University of California, San Diego, San Diego.
Hospital quality measures are a vital component of a learning health system, yet they can be costly to report, statistically underpowered, and inconsistent due to poor interrater reliability. Large language models (LLMs) have recently demonstrated impressive performance on health care-related tasks and offer a promising way to provide accurate abstraction of complete charts at scale. To evaluate this approach, we deployed an LLM-based system that ingests Fast Healthcare Interoperability Resources data and outputs a completed Severe Sepsis and Septic Shock Management Bundle (SEP-1) abstraction.
View Article and Find Full Text PDFHospitals Did Not Increase Acute Occupational Therapy Provision Despite Positive Associations With Hospital Performance Under Medicare's Comprehensive Care for Joint Replacement Program.
Am J Occup Ther
January 2025
Andrew Ryan, PhD, is Professor, Department of Health Services, Brown University, Providence, RI.
Importance: Medicare's Comprehensive Care for Joint Replacement (CJR) program rewards hospitals for reducing total Medicare spending. Despite the benefits of occupational therapy (OT) for patient outcomes and spending, little is known about how CJR affects hospital provision of acute occupational OT services.
Objective: Determine whether CJR changed acute OT provision and whether higher acute OT provision was associated with CJR rewards.
Mandatory Medicare bundled payment and the future of hospital reimbursement.
Am J Manag Care
December 2024
Brandeis University, 415 South St, MS 035, Waltham, MA 02453. Email:
The authors evaluate features of the Transforming Episode Accountability Model and discuss its benefits and limitations.
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