Clinical trial NCT02734043: Roadmap for Succeeding in Bundled Payment for Orthopedic Joint Replacements
Official title: Roadmap for Succeeding in Bundled Payment for Orthopedic Joint Replacements
Study type: OBSERVATIONAL
Overall status: WITHDRAWN
Conditions: Osteoarthritis
Keywords: bundled payment
Lead sponsor: University of Pennsylvania
Sponsor class: OTHER
First posted: 2016-04-12
Enrollment: 0
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Orthopedic surgeons from one health system who participated over a five year span in bundled payment arrangements

Brief 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.

Detailed 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.

Eligibility criteria: 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

Primary outcomes:
measure: Surgical site infection at the physician level
timeFrame: 12 months
Secondary outcomes:
measure: Cost of care during hospitalization
timeFrame: 12 months
measure: Cost of care post-discharge
timeFrame: 12 months
measure: All-cause readmission rate at the physician level
timeFrame: 12 months
measure: Venous thromboembolism at the physician level
timeFrame: 12 months
measure: Cost of care at the physician level
timeFrame: 12 months
measure: Spending at the physician level
timeFrame: 12 months
Other outcomes:
Locations:
Study officials:
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