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Related Experiment Video

Updated: Oct 25, 2025

Utilizing a 3D Printed Laparoscopic Nissen Fundoplication Model to Shorten a Resident's Learning Curve
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Lessons learned from value-based pediatric appendectomy care: A shared savings pilot model.

Yangyang R Yu1, Steven C Mehl1, Kathleen E Carberry2

  • 1Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital and Michael E. DeBakey Department of Surgery, Baylor College of Medicine 6701 Fannin Dr. Suite 1210 Houston, TX 77030, USA.

American Journal of Surgery
|August 8, 2021
PubMed
Summary
This summary is machine-generated.

A shared savings program for pediatric appendectomy improved quality metrics like readmission rates and patient satisfaction but did not achieve cost savings. Future programs need realistic targets and sufficient time for interventions to impact value-based care.

Keywords:
Alternate payment methodsShared savings programValue-based care

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Area of Science:

  • Healthcare Management
  • Value-Based Care
  • Pediatric Surgery

Background:

  • Shared savings programs aim to align payer and provider incentives for improved healthcare value.
  • Assessing the financial and quality outcomes of such programs is crucial for optimizing healthcare delivery.

Purpose of the Study:

  • To evaluate the healthcare value generated by a shared savings program specifically for pediatric appendectomy procedures.
  • To determine if quality targets and cost reduction goals were met within the program's performance periods.

Main Methods:

  • A retrospective analysis of all pediatric appendectomy patients within a health plan was conducted.
  • Quality targets included reductions in time to surgery, length of stay, readmission rates, and improvements in patient satisfaction.
  • Performance was compared across baseline and two 6-month performance periods (PP1, PP2).

Main Results:

  • No quality targets were achieved in the first performance period (PP1).
  • In the second performance period (PP2), readmission rates decreased by 57% and patient satisfaction improved, meeting two quality targets.
  • Despite quality improvements, the program did not achieve cost savings as the -9% cost reduction threshold was not met in either PP1 (+1.7%) or PP2 (-0.4%).

Conclusions:

  • Payer-provider collaborations offer a framework for testing value-based reimbursement models in pediatric surgery.
  • Future shared savings programs should focus on setting achievable quality targets, identifying key performance indicators, accounting for case mix, and allowing adequate time for interventions to demonstrate cost savings.