The potential risk of using historic claims to set bundled payment prices: the case of physical therapy after lower extremity joint replacement.

ABSTRACT:

Background

One of the most significant challenges of implementing a multi-provider bundled payment contract is to determine an appropriate, casemix-adjusted total bundle price. The most frequently used approach is to leverage historic care utilization based on claims data. However, those claims data may not accurately reflect appropriate care (e.g. due to supplier induced demand and moral hazard effects). This study aims to examine variation in claims-based costs of post-discharge primary care physical therapy (PT) utilization after total knee and hip arthroplasties (TKA/THA) for osteoarthritis patients.

Methods

This retrospective cohort study used multilevel linear regression analyses to predict the factors that explain the variation in the utilization of post-discharge PT

SUBMITTER: Steenhuis S 

PROVIDER: S-EPMC9392222 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature