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Overlap between Medicare's Voluntary Bundled Payment and Accountable Care Organization Programs
Amol S Navathe1,2,3,4, Claire Dinh2, Sarah E Dykstra5
1Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania.
Journal of Hospital Medicine
|August 22, 2019
Summary
Accountable care organizations (ACOs) and bundled payments are growing together. By 2016, 10% of ACO patients and 27% of bundled payment patients were in both models, highlighting significant overlap.
Area of Science:
- Health Services Research
- Healthcare Policy
- Value-Based Care
Background:
- Accountable Care Organizations (ACOs) and bundled payments are key value-based payment models.
- The extent of overlap between these two models is not well-documented.
Purpose of the Study:
- To quantify the overlap between ACOs and bundled payments using Medicare data.
- To describe the trends in this overlap between 2013 and 2016.
Main Methods:
- Defined overlap by linking Medicare Shared Savings Program (MSSP) ACO attribution with Bundled Payments for Care Improvement (BPCI) episodes.
- Analyzed Medicare data from 2013 to 2016.
Main Results:
- Overlap increased significantly from 2013 to 2016.
- By 2016, 10% of ACO patients and 27% of bundled payment patients were in overlapping models.
- Overlap varied across different BPCI episodes.
Conclusions:
- This study provides the first quantification of ACO and bundled payment overlap.
- Increasing overlap necessitates policy considerations for clinical and administrative implications.
- Policymakers should address the growing intersection of these value-based payment models.