Bundling payments for all related care within 30 days after an initial hospitalization can reduce the cost of treatment and decrease readmissions for heart failure, according to research published in the American Heart Journal and funded by the Agency for Healthcare Research and Quality.
For their study, researchers at the Duke Clinical Research Institute in Durham, N.C., analyzed the impact of bundling payments for Medicare beneficiaries with heart failure for 30 days or 180 days after hospitalization. With a known 30-day readmission rate of 22.9 percent (median inpatient cost of $9,923 per readmitted patient) and a 180-day readmission rate of 54.1 percent (median cost of $13,463 per readmitted patient), the researchers found that a 30-day disease management program reduced readmissions by 21 percent and cost $477. Additionally, the break-even cost for a 180-day disease management program was $1,530.
The researchers noted that a small number of expensive cases skewed the distribution of 30-day costs for readmitted patients, resulting in an average cost of $17,122. If this was used as the bundled payment, four out of five disease management programs that underwent randomized trials produced cost savings, ranging from $96-$875 per patient, while the fifth produced an additional cost of $52 per patient.
The researchers concluded that if Medicare increased the bundling payments to 180 days, disease management programs would be expected to yield even greater savings.
For their study, researchers at the Duke Clinical Research Institute in Durham, N.C., analyzed the impact of bundling payments for Medicare beneficiaries with heart failure for 30 days or 180 days after hospitalization. With a known 30-day readmission rate of 22.9 percent (median inpatient cost of $9,923 per readmitted patient) and a 180-day readmission rate of 54.1 percent (median cost of $13,463 per readmitted patient), the researchers found that a 30-day disease management program reduced readmissions by 21 percent and cost $477. Additionally, the break-even cost for a 180-day disease management program was $1,530.
The researchers noted that a small number of expensive cases skewed the distribution of 30-day costs for readmitted patients, resulting in an average cost of $17,122. If this was used as the bundled payment, four out of five disease management programs that underwent randomized trials produced cost savings, ranging from $96-$875 per patient, while the fifth produced an additional cost of $52 per patient.
The researchers concluded that if Medicare increased the bundling payments to 180 days, disease management programs would be expected to yield even greater savings.
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