Econometrica performed an evaluation on CMS’ BPCI Initiative to redesign incentives for improving acute care
The Evaluation and Monitoring of the Bundled Payments for Care Improvement (BPCI) Model 1 Initiative examined the BPCI model of alternative payment and service delivery in healthcare. This pivotal project was a major multimillion-dollar evaluation effort for Econometrica and is an ongoing example of our corporate capabilities in evaluation.
The Center for Medicare & Medicaid Innovation, under the Centers for Medicare & Medicaid Services, tests different payment and delivery models that may reduce healthcare expenses while preserving or enhancing quality of care. The BPCI 1 Model Initiative provided financial incentives for redesigns to acute care inpatient hospitals that would support the cost and quality goals.
Incentives include discounting payments hospitals receive for care provided to beneficiaries during an inpatient stay and permitting sharing among hospitals of savings incurred with physicians enrolled in the model (i.e., gainsharing). BPCI Model 1 focuses on the acute care inpatient setting, but participating hospitals are at financial risk for increases in both aggregate Medicare Part A and Part B expenditures 30 days after discharge.
Specific goals of the BPCI Model 1 are reducing provider cost-of-care delivery, maintaining or improving quality of care, and decreasing Medicare payments. The Econometrica Team assessed and oversaw the initiative’s impact, cumulating in a series of annual reports, program monitoring and rapid-cycle quarterly reports, and a final project report with a comprehensive evaluation.
Our team combined qualitative, econometric, and statistical methodologies to examine changes in service utilization patterns, patient case mix, incidence of harm, quality of care, key health outcomes of patients, and Medicare expenditures. Specific analytic tasks were selection of comparison hospitals (nonparticipating hospitals with characteristics statistically similar to participating hospitals), grouping hospitals by similar intervention characteristics, and implementing various quasi-experimental analyses.
We contextualized findings with primary data collected from interviews and focus groups of model participants, focusing on participant activities under BPCI Model 1. Based on the data collected, we produced reports to inform CMS that may affect future models and encourage greater success in care redesign. Our work produced a ready-to-use B-CARE tool that incorporates not only the assessment forms, but also the training and support required for projects to be successful. If implemented, the resulting data would support bundled payments for Medicare, producing better and more affordable healthcare.
Founded in 1998, Econometrica is a research and management organization in Bethesda, MD, established to provide public- and private-sector clients with customized program support services. Econometrica works with multiple agencies to provide high-quality, cost-effective analyses, modeling, and economic evaluations. The company consistently receives exceptional scores from its clients and believes in three principles: technical capabilities, happy customers, and business development.
Our team combined qualitative, econometric, and statistical methodologies to examine changes in service utilization patterns, patient case mix, incidence of harm, quality of care, key health outcomes of patients, and Medicare expenditures.
Read more about the BPCI Model 1 here.
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