Status:
COMPLETED
The Impact of Medicare Bundled Payments
Lead Sponsor:
Amy Finkelstein
Collaborating Sponsors:
Harvard University
University of Chicago
Conditions:
Arthroplasty, Replacement
Eligibility:
All Genders
Phase:
NA
Brief Summary
Bundled payments (BP) are a key part of Medicare's shift away from the traditional fee-for-service (FFS) payment model. The investigators propose to study a nationwide randomized-controlled trial (RCT...
Eligibility Criteria
Inclusion
- Acute care hospital paid under the inpatient prospective payment system (IPPS)
- Hospital admission for major joint replacement or reattachment of lower extremity with and without major complications or comorbidities (MS-DRG 469 and 470)
Exclusion
- MSA exclusion criteria:
- MSAs with low volume of LEJR
- MSAs with high take-up of BPCI
- MSAs with large share of LEJR in Maryland hospitals
- Hospital exclusion criteria:
- Hospitals participating in certain models of BPCI.
- Patient exclusion criteria (the episode is cancelled if any of the following occurs during the episode):
- Patient not covered by both Medicare Parts A and B
- Patient eligibility for Medicare is due to end stage renal disease (ESRD)
- Patient is in a managed care plan
- Patient is in a United Mine Workers of America Plan
- Medicare is not the primary payer for the patient
- Patient dies during the episode
- Patient is re-admitted to an ACH for one of the two CJR DRGs during the episode
- Patient initiates an LEJR episode under BPCI during the episode
- Payments and services that occur in the episode that are excluded are:
- hemophilia clotting factors
- new technology add-on payments
- transitional pass-through payment for medical devices
- payments from certain incentive programs
- otherwise included payments that exceed two standard deviations of the regional mean
- services unrelated to the index admission as defined by CMS (including certain inpatient hospital stays, Part B services, and per beneficiary per month (PBPM) payments).
Key Trial Info
Start Date :
April 1 2016
Trial Type :
INTERVENTIONAL
Allocation :
ACTUAL
End Date :
February 1 2022
Estimated Enrollment :
196 Patients enrolled
Trial Details
Trial ID
NCT03407885
Start Date
April 1 2016
End Date
February 1 2022
Last Update
March 3 2022
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