Lessons learned from value-based pediatric appendectomy care: A shared savings pilot model - 15/12/21
Abstract |
Purpose |
We aim to assess the healthcare value achieved from a shared savings program for pediatric appendectomy.
Methods |
All appendectomy patients covered by our health plan were included. Quality targets were 15% reduction in time to surgery, length of stay, readmission rate, and patient satisfaction. Quality targets and costs for an appendectomy episode in two 6-month performance periods (PP1, PP2) were compared to baseline.
Results |
640 patients were included (baseline:317, PP1:167, PP2:156). No quality targets were met in PP1. Two quality targets were met during PP2: readmission rate (−57%) and patient satisfaction. No savings were realized because the cost reduction threshold (−9%) was not met during PP1 (+1.7%) or PP2 (−0.4%).
Conclusions |
Payer-provider partnerships can be a platform for testing value-based reimbursement models. Setting achievable targets, identifying affectable quality metrics, considering case mix index, and allowing sufficient time for interventions to generate cost savings should be considered in future programs.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Assessed the medical value of a Shared Savings Program for pediatric appendicitis. |
• | Quality targets included time to surgery, length of stay, readmission, and patient satisfaction. |
• | Two quality targets were met during the study period, readmission and satisfaction. |
• | However, no savings were realized because the cost threshold was not met. |
• | Payer-provider partnerships can be a platform for testing value-based reimbursement. |
Keywords : Value-based care, Shared savings program, Alternate payment methods
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Vol 223 - N° 1
P. 106-111 - janvier 2022 Retour au numéro
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