This trial is active, not recruiting.

Conditions osteoarthritis, acute myocardial infarction, congestive heart failure, chronic obstructive pulmonary disease
Sponsor University of Pennsylvania
Start date April 2016
End date April 2017
Trial size 440 participants
Trial identifier NCT02743507, 824812


Bundled payment is a new payment reform that encourages health care providers to improve quality and contain costs of care. These arrangements are being rapidly expanded across the country, but evidence about their impact are lacking. This study will use Medicare claims data to evaluate the effect of participation in a large Medicare bundled payment program on the quality and costs of care for common medical and surgical conditions.

United States No locations recruiting
Other Countries No locations recruiting

Study Design

Observational model case-only
Time perspective retrospective

Primary Outcomes

Unplanned readmission rates
time frame: Up to 90 days
Emergency department utilization rates for patients post-discharge
time frame: 12 months
All-cause mortality
time frame: 12 months

Secondary Outcomes

Total Medicare per patient per episode
time frame: 12 months
Medicare spending per patient for the initial hospitalization
time frame: 12 months

Eligibility Criteria

Male or female participants of any age.

Inclusion Criteria: - Provider organizations that participate in model 2 of the BPCI program, accept bundled payment for the ten most common MS-DRGs, and have at least ten or greater episodes in each of the MS-DRGs. Exclusion Criteria: - Provider organizations who participated in the BPCI program, but do not meet inclusion criteria will be excluded.

Additional Information

Official title The Impact of the Bundled Payments for Care Improvement Program on Quality and Costs of Care
Description The overall objective is to examine the effects of the Bundled Payments for Care Improvement (BPCI) Model 2 on the quality and costs of care for conditions related to the ten disease-related groups (DRGs) most commonly selected by program participation. Six of these ten are surgical (major joint replacement of the lower extremity; double joint replacement of the lower extremity; revision of the hip or knee, hip and femur procedures except major joint; lower extremity and humerus procedure except hip, foot, and femur; coronary artery bypass graft) and four are medical (acute myocardial infarction; congestive heart failure; simple pneumonia and respiratory infections; chronic obstructive pulmonary disease, bronchitis/asthma). These ten medical severity-diagnosis related group (MS-DRGs) (medical represent four larger service lines: orthopedics, cardiology, pulmonary, thoracic surgery). For each of the ten most common MS-DRGs in BPCI, the team will first describe characteristics of provider organizations participating in bundled payment arrangements, including geographic characteristics and clinical volume. We will subsequently empirically test the effect of bundled payment arrangements on quality outcomes and costs of care for these conditions. Additionally, the team will examine any spillover effects that occur within the service lines that contain these ten most common MS-DRGs.
Trial information was received from ClinicalTrials.gov and was last updated in April 2016.
Information provided to ClinicalTrials.gov by University of Pennsylvania.