The Affordable Care Act’s Center for Medicare & Medicaid Innovation (CMMI)’s proposal of Bundled Payments for Care Improvement (BPCI)

Andrew Strohman, Health Policy Data Analyst January 10, 2020

In an effort to find alternative health care payment models that can reduce costs while maintaining quality, the Affordable Care Act created the Center for Medicare & Medicaid Innovation (CMMI). One of CMMI’s proposals is Bundled Payments for Care Improvement (BPCI), which links or “bundles” payments for multiple services.

Results so far indicate that BPCI could reduce costs for some pre-planned medical procedures. A 2017 study in the Journal of Arthroplasty compared Medicare payments for overall orthopedic surgeries between non-BPCI and BPCI patients. The study found that the median expenditures were 12 percent lower for BPCI patients than non-BPCI patients, as displayed below, while median post-acute spending was 22 percent lower for BPCI patients. Corroborating these results is a 2017 JAMA study on average joint-replacement costs for Medicare patients, and other evidence indicates BPCI patients undergoing total joint replacement could have shorter stays in the hospital and fewer discharges to inpatient facilities.

On the other hand, a similar study comparing these payment models for Coronary Artery Bypass Grafts found significant increases in costs for BPCI patients. While more research is needed, this last finding may suggest a more niche role for BPCI with pre-planned orthopedic procedures, but not for emergency cardiac surgeries.

Data obtained from the Journal of Arthroplasty

https://www.americanactionforum.org/weekly-checkup/candidate-health-policy-proposals-not-aligned-with-voter-concerns/#ixzz6B0s554xf
Follow @AAF on Twitter