What question did this study set out to answer?

The aim is to evaluate alternative payment models to improve Medicare efficiency and value for beneficiaries.

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July 2, 2008

Collective Accountability for Medical Care — Toward Bundled Medicare Payments

Key Points

The aim is to evaluate alternative payment models to improve Medicare efficiency and value for beneficiaries.
Analyzed spending differences between high-spending and low-spending regions
Investigated the relationship between spending and quality of care
Explored the impacts of bundled payments on Medicare expenditures
Spending per beneficiary in high-spending regions exceeds low-spending regions by 33%
Quality of care remains unchanged across spending levels
Bundled payment approaches show potential to align incentives for better value.

Abstract

Medicare's projected spending growth is unsustainable. The program already strains the resources of beneficiaries and taxpayers alike and will someday crowd out other public- and private-sector priorities, given that Medicare spending as a percentage of the gross domestic product is expected to nearly double in the next 20 years. At the same time, neither beneficiaries nor taxpayers are getting good value from the program. Per-beneficiary spending in high-spending regions of the country exceeds that in low-spending regions by one third, and yet beneficiaries in high-spending regions receive no better quality of care.1 The incentives inherent in the dominant fee-for-service payment . . .

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