Effects of Medicare bundled payments for colectomy

Editor's Note

In this study from Johns Hopkins, Baltimore, payments for colectomy under Medicare’s Bundled Payments for Care Improvement Initiative were lower than a fee-for-service payment model, and the proportion of patients contributing to a net negative margin increased. Net negative margins were calculated as the difference between total hospital costs and total payments received.

Of 821 patients analyzed, 33.7% contributed to an overall negative margin under a fee-for-service payment model, and 41.7% contributed to an overall negative margin under the bundled payment model.

Results show that current payment models may allow for a significant mismatch in financial incentive, quality of care, and willingness of hospitals to take on high-risk patients in a bundled payment system, the authors say.