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Your search keyword '"Werner, Rachel M"' showing total 31 results
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31 results on '"Werner, Rachel M"'

30. Overlap between Medicare's Voluntary Bundled Payment and Accountable Care Organization Programs.

Author

Navathe AS, Dinh C, Dykstra SE, Werner RM, and Liao JM

Subjects
Aged, Hospitalization, Hospitals, Humans, Medicare, Reimbursement Mechanisms, United States, Accountable Care Organizations
Abstract

Accountable care organizations (ACOs) and bundled payments represent prominent value-based payment models, but the magnitude of overlap between the two models has not yet been described. Using Medicare data, we defined overlap based on attribution to Medicare Shared Savings Program (MSSP) ACOs and hospitalization for Bundled Payments for Care Improvement (BPCI) episodes at BPCI participant hospitals. Between 2013 and 2016, overlap as a share of ACO patients increased from 2.7% to 10% across BPCI episodes, while overlap as a share of all bundled payment patients increased from 19% to 27%. Overlap from the perspectives of both ACO and bundled payments varied by specific episode. In the first description of overlap between ACOs and bundled payments, one in every ten MSSP patients received care under BPCI by the end of our study period, whereas more than one in every four patients receiving care under BPCI were also attributed to MSSP. Policymakers should consider strategies to address the clinical and policy implications of increasing payment model overlap.

Published
2020
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31. Do Hospitals Participating in Accountable Care Organizations Discharge Patients to Higher Quality Nursing Homes?

Author

Bain AM, Werner RM, Yuan Y, and Navathe AS

Subjects
Aged, 80 and over, Female, Hospitals, Humans, Male, Medicare, Patient Readmission, United States, Accountable Care Organizations, Patient Discharge statistics & numerical data, Quality of Health Care statistics & numerical data, Skilled Nursing Facilities standards, Skilled Nursing Facilities statistics & numerical data
Abstract

We examined whether hospitals participating in Medicare's Shared Saving Program increased the use of highly rated skilled nursing facilities (SNFs) or decreased the use of low-rated SNFs hospital-wide after initiation of their accountable care organization (ACO) contracts compared with non-ACO hospitals. Using a difference-in-differences design, we estimated the change in the probability of discharge to 5-star and 1-star SNFs among all beneficiaries discharged from ACO-participating hospitals after the hospital initiated ACO participation. After joining an ACO, the percentage of hospital discharges going to a high-quality SNF increased by 3.4 percentage points on a base of 15.4% (95% confidence interval [CI] 1.3-5.5, P = .002) compared with non-ACO-participating hospitals. The probability of discharge from an ACO-participating hospital to low-quality SNFs did not change significantly compared with non-ACO-participating hospitals. Our findings indicate that ACO-participating hospitals were more likely to discharge patients to highly rated SNFs after they began their ACO contract but did not change the likelihood of discharge to lower rated SNFs in comparison with non-ACO hospitals.

Published
2019
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