Hospital and Physician Group Practice Participation in Prior and Next-Generation Value-Based Payment Programs

Kang, So-Yeon; Anderson, Gerard

doi:10.1001/jamanetworkopen.2024.0392

JAMA Netw Open

2024

DOI: 10.1001/jamanetworkopen.2024.0392

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Hospital and Physician Group Practice Participation in Prior and Next-Generation Value-Based Payment Programs

So-Yeon Kang,

Gerard Anderson

Abstract: This cohort study examines whether prior direct or indirect participation in the Centers for Medicare &amp; Medicaid Innovation Bundled Payments for Care Improvement (BCPI) Initiative was associated with their participation in the next generation of the program.

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Association of Hospitals' Experience with Bundled Payment for Care Improvement Model with the Diffusion of Acute Hospital Care at Home

Kang

2024

Health Services Research

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ObjectiveTo examine whether hospitals' experience in a prior payment model incentivizing care coordination is associated with their decision to adopt a new payment program for a care delivery innovation.Data SourcesData were sourced from Medicare fee‐for‐service claims in 2017, the list of participants in Bundled Payment for Care Improvement initiatives (BPCI and BPCI‐Advanced), the list of hospitals approved for Acute Hospital Care at Home (AHCaH) between November 2020 and August 2022, and the American Hospital Association Survey.Study DesignRetrospective cohort study. Hospitals' adoption of AHCaH was measured as a function of hospitals' BPCI experiences. Hospitals' BPCI experiences were categorized into five mutually exclusive groups: (1) direct BPCI participation, (2) indirect participation through physician group practices (PGPs) after dropout, (3) indirect participation through PGPs only, (4) dropout only, and (5) no BPCI exposure.Data Collection/Extraction MethodsAll data are derived from pre‐existing sources. General acute hospitals eligible for both BPCI initiatives and AHCaH are included.Principal FindingsOf 3248 hospitals included in the sample, 7% adopted AHCaH as of August 2022. Hospitals with direct BPCI experience had the highest adoption rate (17.7%), followed by those with indirect participation through BPCI physicians after dropout (11.8%), while those with no exposure to BPCI were least likely to participate (3.2%). Hospitals that adopted AHCaH were more likely to be located in communities where more peer hospitals participated in the program (median 10.8% vs. 0%). After controlling for covariates, the association of the adoption of AHCaH with indirect participation through physicians after dropout was as strong as with early BPCI adopter hospitals (average marginal effect: 5.9 vs. 6.2 pp, p < 0.05), but the other categories were not.ConclusionsHospitals that participated in the bundled payment model either directly or indirectly PGPs were more likely to adopt a care delivery innovation requiring similar competence in the next period.

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Association of Hospitals' Experience with Bundled Payment for Care Improvement Model with the Diffusion of Acute Hospital Care at Home

Kang

2024

Health Services Research

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Hospital and Physician Group Practice Participation in Prior and Next-Generation Value-Based Payment Programs

Abstract: This cohort study examines whether prior direct or indirect participation in the Centers for Medicare &amp; Medicaid Innovation Bundled Payments for Care Improvement (BCPI) Initiative was associated with their participation in the next generation of the program.

Cited by 1 publication

References 5 publications

Association of Hospitals' Experience with Bundled Payment for Care Improvement Model with the Diffusion of Acute Hospital Care at Home

Association of Hospitals' Experience with Bundled Payment for Care Improvement Model with the Diffusion of Acute Hospital Care at Home

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Hospital and Physician Group Practice Participation in Prior and Next-Generation Value-Based Payment Programs

Abstract: This cohort study examines whether prior direct or indirect participation in the Centers for Medicare &amp;amp; Medicaid Innovation Bundled Payments for Care Improvement (BCPI) Initiative was associated with their participation in the next generation of the program.

Cited by 1 publication

References 5 publications

Association of Hospitals' Experience with Bundled Payment for Care Improvement Model with the Diffusion of Acute Hospital Care at Home

Association of Hospitals' Experience with Bundled Payment for Care Improvement Model with the Diffusion of Acute Hospital Care at Home

Contact Info

Product

Resources

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Abstract: This cohort study examines whether prior direct or indirect participation in the Centers for Medicare & Medicaid Innovation Bundled Payments for Care Improvement (BCPI) Initiative was associated with their participation in the next generation of the program.