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Effect of Implementing a Bundled-Payment Program for Heart Failure at a Safety-Net Community Hospital

Jonathan Lichkus1, Christina Wolf2, Robin Hynds2

  • 11 Greater Lawrence Family Health Center , Lawrence, Massachusetts.

Population Health Management
|May 30, 2018
PubMed

Insights

Safety net hospitals can succeed in bundled payment programs for heart failure. This study shows a bundled-payment program generated savings and was financially feasible for a community hospital.

Area of Science:

  • Health economics
  • Healthcare management
  • Clinical outcomes

Background:

  • Safety net community hospitals face financial challenges with risk-based contracts.
  • The financial viability of bundled payment programs in these settings is understudied.

Purpose of the Study:

  • To analyze the financial performance and outcomes of a bundled-payment program for congestive heart failure at a safety net community hospital.

Main Methods:

  • Calculated net patient payment by quarter post-implementation.
  • Compared cost drivers, including next site of care and readmission rates, before and after the bundle.

Main Results:

  • The program generated savings and positive financial returns after 21 months.
  • Skilled nursing facility admissions decreased from 21.3% to 16.0%.
  • Readmission rates showed a downward trend but were not statistically significant.

Conclusions:

  • Safety net community hospitals can successfully implement bundled-payment programs.
  • Reducing skilled nursing facility admissions is crucial for program success in heart failure care.

Keywords:
bundled paymentheart failurepost-acute care facilitiesvalue-based health care

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