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April 14, 2017

Study: Hospital participation in voluntary value-based programs leads to lower readmission rates, costs

Daily Briefing

Hospitals that participated in at least one of three voluntary value-based care initiatives reported a greater reduction in readmission rates than those that did not participate, according to a study published on Monday in JAMA Internal Medicine.

Study details

For the study, researchers from the University of Michigan examined publicly available data from 2008 to 2015 on readmission rates from 2,837 hospitals for acute myocardial infarction (AMI), heart failure, and pneumonia, three conditions that are targeted under CMS' mandatory Hospital Readmissions Reduction Program (HRRP).

The researchers used the data to assess whether significant improvements in lowering readmissions were associated with hospital participation in three voluntary federal value-based care initiatives:

  • Meaningful use, which launched in 2011;
  • The Bundled Payment for Care Initiative (BPCI), which launched in 2013; and
  • Medicare's Pioneer and Shared Savings accountable care organization (ACO) programs, which launched in 2012.

The Pioneer ACO program concluded in December 2016.

According to JAMA, by 2015 only 56 of the 2,837 hospitals examined were not involved in at least one of the initiatives.

Study findings: Participating hospitals report cost savings

The study found that hospitals enrolled in at least one of the three voluntary federal reform initiatives saw greater reductions in 30-day readmission rates than those that participated in HRRP alone.

Alternative payment model participation soars. Here's how to think about it.

For example, hospitals that did not participate in at least one of the reforms experienced a 1.3 percent annual decrease in the 30-day readmission rate for heart failure, but those that participated in the ACO reported a 2.1 percent annual decrease, and those in the meaningful use program experienced a 2.3 percent annual reduction. Hospitals involved in all three of the initiatives saw the greatest declines in readmission rates for heart failure, dropping by about 2.9 percent annually, the study found. The trends were similar for the other two conditions studied.

The study attributed the reduction in readmissions among nonparticipating hospitals to the fines levied under HRRP.

In addition to reducing readmissions rates, hospital participation in the three initiatives generated nearly $32 million in cost savings from reduced readmissions in 2015.

Andrew Ryan, the study's lead author and an associate professor at the University of Michigan, said the findings are "encouraging" and indicate that "these value programs are reinforcing the broader push to value-based care." He added that the study demonstrates "the importance of a multi-pronged Medicare strategy to improve quality and value" (Punke, Becker's Hospital Review, 4/10; Minemyer, FierceHealthcare, 4/11; Ryan et al., JAMA, 4/10; University of Michigan release, 4/10).

Finding wins under MSSP


Last year only 30 percent of ACOs participating in MSSP generated enough savings to qualify for bonus payments. Trying to balance cost and quality measures can seem impossible to qualify for bonus payments. This resource explores how three members from our cohort have achieved big wins in MSSP and qualified for bonus payments.

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