Roadmap for Succeeding in Bundled Payment for Orthopedic Joint Replacements

Osteoarthritis Clinical Trial

Official title:

Roadmap for Succeeding in Bundled Payment for Orthopedic Joint Replacements

Clinical Trial Details — Status: Withdrawn

Administrative data

• NCT number: NCT02734043
• Other study ID #: 824614
• Status: Withdrawn
• Start date: March 2016
• Est. completion date: May 2018

Study information

• Verified date: October 2018
• Source: University of Pennsylvania
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

The objective of the study is to provide a road map that can help organizational leaders understand how to sequence their financial and human capital investments related to bundled payment arrangements. Although specific strategies will vary between organizations, providing evidence from a health system with extension experience bundling care for orthopedic joint replacements can be instructive for other providers entering new building arrangements. Insights from the experience of the health system can help other organizations prioritize effort and focus energy around strategies that increase the likelihood of succeeding under Comprehensive Care for Joint Replacement (CJR) and other bundled payment contracts.

Description:

This study will analyze data from a health system with the longest standing experience with bundled payments for orthopedic procedures. The goal of this work is to provide insights from this health system's six years of experience and offer a road map that other organizations around the country can use as they plan and implement their own bundled payment programs. The investigators will conduct a retrospective analysis on quality and cost data from a health system with extensive experience with bundled payments for orthopedic joint replacements. The study design will consist of three parts: first, the team will report trends in quality and cost outcomes over time using descriptive statistics; second, the team will perform multi-variable regression analyses on the data to identify significant predictors of different quality and cost outcomes and provide statistical tests on the trends; third, the team will evaluate changes in physician and hospital level variation along the outcomes.

Recruitment information / eligibility

• Status: Withdrawn
• Enrollment: 0
• Est. completion date: May 2018
• Est. primary completion date: May 2018
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• participants in this study will be physicians participating in the bundled payment arrangement at the health system in question. All physicians will be included in the analysis.

Exclusion Criteria:

• no exclusion criteria

Related Conditions & MeSH terms

• Osteoarthritis

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
University of Pennsylvania

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Surgical site infection at the physician level	The study team will evaluate at the physician level. The quality metric evaluated will be average rate of surgical site infections.	12 months
Secondary	Cost of care during hospitalization	The study team will measure secondary cost outcome variables on the episode level. The cost metric to be evaluated is per episode costs of care during the hospitalization in which the surgery occurred.	12 months
Secondary	Cost of care post-discharge	The study team will measure secondary cost outcome variables on the episode level. The cost metric to be evaluated is per episode costs of care post-discharge.	12 months
Secondary	All-cause readmission rate at the physician level	The study team will evaluate at the physician level. The quality metric measured will be all-cause readmission rate.	12 months
Secondary	Venous thromboembolism at the physician level	The study team will evaluate at the physician level. The quality metric measured will be the rate of venous thromboembolism per physician in each quarter of analysis.	12 months
Secondary	Cost of care at the physician level	The study team will evaluate at the physician level. The cost metric evaluated will be the average costs of care during hospitalization in which the surgery occurred.	12 months
Secondary	Spending at the physician level	The study team will evaluate at the physician level. The cost metric evaluated will be average spending on care in combined hospitalization and post-discharge periods per physician in each quarter of analysis.	12 months