Dataset Information

Impact of an Episode-Based Payment Initiative by Commercial Payers in Arkansas on Procedure Volume: an Observational Study.

ABSTRACT:

Background

Episode-based payment (EBP) is gaining traction among payers as an alternative to fee-for-service reimbursement. However, there is concern that EBP could influence the number of episodes.

Objective

To examine how procedure volume changed after the introduction of EBP in 2013 and 2014 under the Arkansas Health Care Payment Improvement Initiative.

Design

Using 2011-2016 commercial claims data, we estimate a difference-in-differences model to assess the impact of EBP on the probability of a beneficiary having an episode for four procedures that were reimbursed under EBP in Arkansas: total joint replacement, cholecystectomy, colonoscopy, and tonsillectomy.

Participants

Commercially insured beneficiaries in Arkansas serve as our treatment group, while commercially insured beneficiaries in neighboring states serve as our comparison group.

Interventions

Statewide implementation of EBP for various clinical conditions by two of Arkansas' largest commercial insurers.

Main measures

For a given procedure type, the primary outcomes are the annual rate of procedures (number of procedures per 1000 beneficiaries) and the probability of a beneficiary undergoing that procedure in a given quarter.

Key results

The relationship between EBP and procedure volume varies across procedures. After EBP was implemented, the probability of undergoing colonoscopy increased by 17.2% (point estimate, 2.63; 95% CI, 1.18 to 4.08; p?ConclusionsWe do not find clear evidence of deleterious volume expansion. However, because the impact of EBP on procedure volume may vary by procedure, payers planning to implement EBP models should be aware of this possibility.

SUBMITTER: Chen JL

PROVIDER: S-EPMC7018907 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Publications

Impact of an Episode-Based Payment Initiative by Commercial Payers in Arkansas on Procedure Volume: an Observational Study.

Chen Julius L JL Chernew Michael E ME Fendrick A Mark AM Thompson Joseph W JW Rose Sherri S

Journal of general internal medicine 20190916 2

<h4>Background</h4>Episode-based payment (EBP) is gaining traction among payers as an alternative to fee-for-service reimbursement. However, there is concern that EBP could influence the number of episodes.<h4>Objective</h4>To examine how procedure volume changed after the introduction of EBP in 2013 and 2014 under the Arkansas Health Care Payment Improvement Initiative.<h4>Design</h4>Using 2011-2016 commercial claims data, we estimate a difference-in-differences model to assess the impact of EB ...[more]

PMID: 31529377

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Dataset Information

Impact of an Episode-Based Payment Initiative by Commercial Payers in Arkansas on Procedure Volume: an Observational Study.

Background

Objective

Design

Participants

Interventions

Main measures

Key results

Publications

Impact of an Episode-Based Payment Initiative by Commercial Payers in Arkansas on Procedure Volume: an Observational Study.

Similar Datasets

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