Continued spending growth in Medicare has led to numerous payment reforms in the years following the ACA. One prominent reform is “Bundled Payment for Care Improvement Advanced.” In this voluntary program, hospitals receive bonuses or penalties based on spending patterns in the 90 days following certain hospitalizations. In this talk, I show that the program has failed, increasing net spending for Medicare. This failure results from several program design flaws related to the interaction between voluntary hospital participation and mis-priced targets. Our research highlights the broader “win-win” fallacy inherent in Medicare’s voluntary payment reforms. In light of this failure, I consider alternative reforms to meet Medicare’s goals. Dr. Ryan is the UnitedHealthcare Professor of Health Care Management in the Department of Health Management and Policy at the University of Michigan School of Public Health. He is the Director of the Center for Evaluating Health Reform and the faculty lead of the Data and Methods Hub for the Institute for Healthcare Policy and Innovation. Dr. Ryan’s research focuses on understanding and evaluating the effects of value-based payment in healthcare. He won the 2009 AcademyHealth Dissertation Award for his dissertation, “The Design of Value-Based Purchasing in Medicare: Theory and Empirical Evidence” and the John M. Eisenberg Article-of-the-Year in Health Services Research for “Has Pay-for-Performance Decreased Access for Minority Patients?” His work has been supported by the Agency for Healthcare Research and Quality, the National Institute on Aging, and the Robert Wood Johnson Foundation.
Simone SinghSaving a bundle? Understanding the impact of Medicare’s new hospital bundled payment program
HMP Faculty Research Seminar with Dr. Andy Ryan
December 2, 2021
12:00 pm - 1:30 pm
Online in Zoom
Contact Information: Simone Singh
Continued spending growth in Medicare has led to numerous payment reforms in the years following the ACA. One prominent reform is “Bundled Payment for Care Improvement Advanced.” In this voluntary program, hospitals receive bonuses or penalties based on spending patterns in the 90 days following certain hospitalizations. In this talk, I show that the program has failed, increasing net spending for Medicare. This failure results from several program design flaws related to the interaction between voluntary hospital participation and mis-priced targets. Our research highlights the broader “win-win” fallacy inherent in Medicare’s voluntary payment reforms. In light of this failure, I consider alternative reforms to meet Medicare’s goals. Dr. Ryan is the UnitedHealthcare Professor of Health Care Management in the Department of Health Management and Policy at the University of Michigan School of Public Health. He is the Director of the Center for Evaluating Health Reform and the faculty lead of the Data and Methods Hub for the Institute for Healthcare Policy and Innovation. Dr. Ryan’s research focuses on understanding and evaluating the effects of value-based payment in healthcare. He won the 2009 AcademyHealth Dissertation Award for his dissertation, “The Design of Value-Based Purchasing in Medicare: Theory and Empirical Evidence” and the John M. Eisenberg Article-of-the-Year in Health Services Research for “Has Pay-for-Performance Decreased Access for Minority Patients?” His work has been supported by the Agency for Healthcare Research and Quality, the National Institute on Aging, and the Robert Wood Johnson Foundation.
