Abt Finds Bundled Payments Do Not Preclude Quality Care For Medicare Patients

June 10, 2019

Rockville, Md. – Can we lower the cost of health care without sacrificing quality? A new study by Abt Global in partnership with The Lewin Group and the Centers for Medicare & Medicaid Services (CMS) suggests the answer is “yes.”

CMS implemented the Bundled Payments for Care Improvement (BPCI) initiative to encourage providers to deliver care more efficiently with equal or better quality. To determine if keeping costs under a predetermined target price resulted in reduced care quality—or increased adverse patient experiences—Abt surveyed nearly 30,000 Medicare beneficiaries treated by hospitals participating in the BPCI initiative and 30,000 others in a matched comparison group.

Key Findings:

Recovery of physical and mental function. BPCI survey respondents reported the same functional status months after their hospitalization as those not in BPCI. This is reassuring evidence that the efficiency incentives in BPCI did not jeopardize patient functional recovery.

Positive care experiences. Among both BPCI and comparison survey respondents:
- More than 95 percent felt their health needs were manageable after returning home.
- Nearly 95 percent agreed that medical staff clearly explained how to take medications, and what follow-up appointments would be needed.
- Nearly 90 percent indicated that they were discharged at the right time.

Some room for improvement may remain. Despite positive care experiences overall, survey results suggest BPCI respondents were slightly less likely than comparison respondents to report the most favorable care experience across several measures. This may suggest a need for greater communication and shared decision making between patients and the BPCI care teams.

“Our findings highlight the value of measuring patient‐reported outcomes as a component of care quality when evaluating new payment and delivery models of care,” said Andrea Hassol, Abt principal associate and study coauthor. “While the study may not generalize to all Medicare beneficiaries, it should reduce concerns about the likelihood of bundled payments harming patients’ health.”

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