Medicare Advantage Bundled Payment Model Tied to Less Skilled Nursing Facility Use

Humana's Medicare Advantage bundled payment model for hip and knee replacements has demonstrated notable benefits. A study published in JAMA Network reveals reduced utilization of skilled nursing facilities (SNFs) and decreased spending on lower extremity joint replacements (LEJR), all while maintaining high-quality care. Among the study's findings, only 780 out of 6,355 bundled episodes for MA beneficiaries necessitated SNF stays, compared to 4,021 out of 16,679 in control episodes. Physician practice involvement in bundled payment programs correlated with a 2.7% reduction in spending, without compromising quality, resulting in approximately $598 less spending per episode. Additionally, practices engaged in the Bundled Payments for Care Improvement initiative within accountable care organizations (ACOs) achieved greater savings than those in traditional Medicare bundled payment programs, as reviewed by the Medicare Shared Savings Program.