Hospitals

For hospitals, value-based care could actually equal lower readmission rates

A new study from JAMA Internal Medicine found hospitals participating in one or more value-based programs have lower readmission rates.

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In recent years, there’s been much hullabaloo surrounding value-based care. Are value-based initiatives truly effective? Are they helping or harming physicians? How do things change when you add telehealth to the equation?

A recent study in JAMA Internal Medicine outlined a few positive gains for value-based care initiatives and their effect on hospitals. The study found hospitals participating in one or more value-based programs have lower readmission rates.

As part of the study, researchers analyzed 2,837 U.S. hospitals between 2008 and 2015. The researchers used publicly available national data from Hospital Compare to look at the hospitals’ 30-day readmission rates for patients with heart attacks, heart failure and pneumonia.

Specifically, they assessed the hospitals’ participation in three voluntary value-based care programs: Meaningful Use, bundled payments and accountable care organizations. “We used an interrupted time series design to test whether hospitals’ time-varying participation in these value-based reforms was associated with greater improvement in Medicare’s [Hospital Readmission Reduction Program],” the researchers wrote.

Because the researchers analyzed the hospitals over a seven-year period, one of their primary findings involves a drastic change in the number of hospitals participating in value-based programs. In 2010, none of the 2,837 hospitals were participating in Meaningful Use, bundled payment or ACO programs. But five years later, 2,781 hospitals were participating in at least one of the programs.

Among those 56 hospitals that weren’t participating in voluntary value-based care initiatives, 30-day readmission rates decreased 1.3 percent annually.

But for the hospitals participating in just an ACO, readmission rates dropped 2.1 percent per year. Hospitals only participating in the Meaningful Use program saw a 2.3 percent reduction in readmission rates annually.

And the reduction rate was greatest among hospitals participating in all three value-based programs. Hospitals that took part in Meaningful Use, bundled payments and ACOs had a 2.9 percent reduction in readmission rates.

The reduced readmissions aren’t the only noticeable change, though. The researchers also found that the combined impact of all three programs led to $32 million in cost savings in 2015.

In a statement, the study’s lead author — Andrew Ryan, PhD, associate professor in the University of Michigan School of Public Health — underlined the benefits of value-based care:

We’re having the chance to learn from Medicare’s experiments to improve value. The programs haven’t been an unmitigated success but we see places they are working. … We should be optimistic about how successful these programs are. It would be a shame to put the brakes on now. This is the right way to pay for healthcare.

Despite some negativity surrounding value-based care and an uncertain future regarding the ACA, it looks like value-based initiatives could be one of the first steps in improving American healthcare.

Photo: Hong Li, Getty Images