Variation in expenditure for common, high cost surgical procedures in a working age population: implications for reimbursement reform
Abstract
In the move toward value-based care, bundled payments are believed to reduce waste and improve coordination. Some commercial insurers have addressed this through the use of bundled payment, the provision of one fee for all care associated with a given index procedure. This system was pioneered by Medicare, using a population generally over 65 years of age, and despite its adoption by mainstream insurers, little is known of bundled payments’ ability to reduce variation or cost in a working-age population. This study uses a universally-insured, nationally-representative population of adults aged 18–65 to examine the effect of bundled payments for five high-cost surgical procedures which are known to vary widely in Medicare reimbursement: hip replacement, knee replacement, coronary artery bypass grafting (CABG), lumbar spinal fusion, and colectomy.
Document Details
- Document Type
- Pub Defense Publication
- Publication Date
- Nov 21, 2019
- Source ID
- 10.1186/s12913-019-4729-2
Entities
People
- A. Navathe
- A. Schoenfeld
- C. Madsen
- C. Tompkins
- Jonathan Weissman
- N. K. Kwon
- P. A. Learn
- S. Lipsitz
- Tracey Koehlmoos
- W. Wynn-jones
Organizations
- Defense Health Agency