Click to access BPCI_Report_Final_0.pdf

A recent study linked Medicare’s Bundled Payment for Care Improvement (BPCI) focusing on lower extremity joint replacements to lower costs of care. An accompanying editorial disputed the findings claiming that a reported rise in the volume of procedures between baseline and performance years for the intervention cohort, relative to a comparison group, indicated that total spend may have increased instead of decreasing.

Our analysis of Medicare fee-for-service data from 2010 through 2015 by hospital, for all lower extremity joint replacements in the entire United States, indicates no evidence that participation in the BPCI was responsible for any increase in the volume of procedures between baseline and performance years, thus reaffirming the original paper’s findings. We also find that trends in regional demographic and market characteristics explain the change in volume over time.