Assessing the Size and Significance of Provider Variability in Payment Bundles

• Activity Number: 564 - Statistical Integrity of Health Services: Detecting Fraud and Improving Data Quality
• Type: Topic Contributed
• Date/Time: Wednesday, August 2, 2017 : 2:00 PM to 3:50 PM
• Sponsor: Health Policy Statistics Section
• Author(s): Peter Bouman*
• Companies: IBM
• Keywords: Administrative data ; Bundled payments ; Medicare ; Quality improvement ; Practice patters

Abstract

Anecdotal evidence suggests that post-acute care pathways are most heavily influenced by the community standard which influences patient expectations/preference and thus influences the discharge disposition. However, it is important to understand the contribution of patient characteristics and physician practice patterns to the total variance in the price of a bundle. We will describe a methodology to measure the portion of bundle price variability "expected" based on patient characteristics known at the time of discharge. The goal is to measure the amount of variability explained by patient characteristics and by differences in physician behavior. This analysis will be completed using claims data provided by Medicare to several contracting providers. Future analyses will add clinical data extracted from the providers' electronic medical records system.