TY - JOUR
T1 - Physician Group Practices Accrued Large Bonuses Under Medicare’s Bundled Payment Model, 2018–20
AU - Shashikumar, Sukruth A.
AU - Chopra, Zoey
AU - Buxbaum, Jason D.
AU - Maddox, Karen E.Joynt
AU - Ryan, Andrew M.
N1 - Publisher Copyright:
© 2024 Project HOPE— The People-to-People Health Foundation, Inc.
PY - 2024/5
Y1 - 2024/5
N2 - The Bundled Payments for Care Improvement Advanced Model (BPCI-A), a voluntary Alternative Payment Model for Medicare, incentivizes hospitals and physician group practices to reduce spending for patient care episodes below preset target prices. The experience of physician groups in BPCI-A is not well understood. We found that physician groups earned $421 million in incentive payments during BPCI-A’s first four performance periods (2018–20). Target prices were positively associated with bonuses, with a mean reconciliation payment of $139 per episode in the lowest decile of target prices and $2,775 in the highest decile. In the first year of the COVID-19 pandemic, mean bonuses increased from $815 per episode to $2,736 per episode. These findings suggest that further policy changes, such as improving target price accuracy and refining participation rules, will be important as the Centers for Medicare and Medicaid Services continues to expand BPCI-A and develop other bundled payment models.
AB - The Bundled Payments for Care Improvement Advanced Model (BPCI-A), a voluntary Alternative Payment Model for Medicare, incentivizes hospitals and physician group practices to reduce spending for patient care episodes below preset target prices. The experience of physician groups in BPCI-A is not well understood. We found that physician groups earned $421 million in incentive payments during BPCI-A’s first four performance periods (2018–20). Target prices were positively associated with bonuses, with a mean reconciliation payment of $139 per episode in the lowest decile of target prices and $2,775 in the highest decile. In the first year of the COVID-19 pandemic, mean bonuses increased from $815 per episode to $2,736 per episode. These findings suggest that further policy changes, such as improving target price accuracy and refining participation rules, will be important as the Centers for Medicare and Medicaid Services continues to expand BPCI-A and develop other bundled payment models.
UR - http://www.scopus.com/inward/record.url?scp=85192634423&partnerID=8YFLogxK
U2 - 10.1377/hlthaff.2023.00915
DO - 10.1377/hlthaff.2023.00915
M3 - Article
C2 - 38709974
AN - SCOPUS:85192634423
SN - 0278-2715
VL - 43
SP - 623
EP - 631
JO - Health Affairs
JF - Health Affairs
IS - 5
ER -