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Bundled Payment Initiative Had No Effect on COPD Readmissions

Multidisciplinary care/transition intervention didn’t reduce readmissions or achieve substantial savings

FRIDAY, Dec. 30, 2016 (HealthDay News) — Implementation of the Medicare Bundled Payments for Care Improvement (BPCI) initiative has failed to cut readmission rates following hospitalization for acute exacerbation of chronic obstructive pulmonary disease (COPD), according to a study published online Dec. 22 in the Annals of the American Thoracic Society.

Surya P. Bhatt, M.D., from University of Alabama at Birmingham, and colleagues compared all-cause readmissions and costs following index hospitalization for consecutive Medicare-only patients with acute exacerbation of COPD before (109 patients in 2012) and after (78 patients in 2014) implementation of a comprehensive, multidisciplinary intervention focusing on inpatient, transitional, and outpatient care as participation in a BPCI initiative.

The researchers found that patients in BPCI were more likely to receive regular follow-up phone calls, pneumococcal and influenza vaccines, home health care, durable medical equipment, pulmonary rehabilitation, and to attend pulmonary clinic. However, there was no difference in all-cause readmission rates at 30 days (BPCI, 15.4 percent; non-BPCI, 17.4 percent; P = 0.711), and 90 days (26.9 versus 33.9 percent; P = 0.306). Before accounting for significant investment from the health system, 90-day costs were 4.3 percent lower, compared to BPCI target prices.

“A Medicare BPCI intervention did not reduce 30-day all-cause readmission rates or overall costs following hospitalization for acute exacerbation of COPD,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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