New Study Finds Medicare Program Maintains Patient Reported Outcomes Among Vulnerable Populations While Reducing Medicare Payments

October 18, 2021

Rockville, Md. – The Bundled Payments for Care Improvement (BPCI) initiative was designed by the Centers for Medicare & Medicaid Services (CMS) to lower Medicare payments while maintaining or improving patient health outcomes. A new study of outcomes reported directly by patients, published in the journal Medical Care, finds that the BPCI initiative met its goal of maintaining patient health outcomes, including among beneficiaries who may be especially vulnerable to reductions in care. The study, conducted by Abt Global and the Lewin Group for CMS, is the latest in a series of evaluations of the CMS BPCI initiative.

For this study, Abt surveyed four groups of beneficiaries: low-income beneficiaries, beneficiaries with dementia, beneficiaries with recent institutional care, and beneficiaries identified as racial/ethnic minorities who were treated at hospitals for heart failure, sepsis, pneumonia, or who received a knee or hip replacement. Patients at BPCI-participating hospitals reported no difference in their functional health status. However, beneficiaries with congestive heart failure, sepsis, and pneumonia were less likely to indicate positive care experiences in at least one of the four groups of beneficiaries studied.

“The good news is we continue to see positive similar outcomes for patients, even as BPCI was associated with reduced Medicare payments, and even for these patients who could be considered more vulnerable,” said the study’s lead author, Abt’s Sean McClellan, Ph.D.

The findings are in keeping with previous studies, which have reduced Medicare payments without diminished outcomes in broader groups of patients treated for the same health issues.

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