(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 in the Annals of the American Thoracic Society.
Surya P. Bhatt, MD, 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%; non-BPCI, 17.4%; P=.711), and 90 days (26.9% vs 33.9%; P=.306). Before accounting for significant investment from the health system, 90-day costs were 4.3% 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.
- Bhatt SP, Wells JM, Iyer AS, et al. Results of a Medicare Bundled Payments for Care Improvement initiative for COPD readmissions. Ann Am Thorac Soc. 2016. Published December 22, 2016.