Studies presented at AcademyHealth’s Annual Research Meeting (ARM) reveal unintended policy effects aimed at combatting the opioid crisis and cost-reduction efforts through bundled payment participation in Medicare.
“The complexity of the dynamics of our health care system means that no policy proposal is cut and dry,” said Kristin Rosengren, AcademyHealth’s vice president of strategic communications. “The challenge in health policy is being able to tease out when- and for whom- changes are improvements. The studies presented at this year’s Annual Research Meeting underline how important it is that we continue to produce evidence to help policymakers make informed decisions.”
Key studies on this topic at this year’s ARM include:
- Implementation of the Tennessee Fetal Assault Law Was Significantly Associated with Higher Rates of Late or No Prenatal Care Among High-Risk Populations
As the opioid epidemic rages on, a considerable number of babies suffer from neonatal abstinence syndrome, a group of conditions that occur when a baby withdraws from drugs they were exposed to in the womb. Several states are considering policies that would treat substance use during pregnancy as child abuse. However, researchers from the Pennsylvania State University found that prenatal care utilization among high-risk populations declined after a Tennessee implemented a law criminalized substance use during pregnancy.
- Association of Participation in Bundled Payments for Medical Conditions with Changes in Spending and Utilization: A Longer-Term Look at the Bundled Payments
Bundling payments for an episode of care has shown savings for lower joint replacement surgery, but is less well-studied for medical conditions. Using Medicare claims data, researchers from the University of Pennsylvania looked at bundling payments for beneficiaries with congestive heart failure, pneumonia, acute myocardial infarction (AMI), or chronic obstructive pulmonary disorder (COPD). They found that although bundled payment participation was associated with no changes in total spending*, there was a shift in post-acute care from skilled nursing to less expense home health. However, this shift was associated with an increased readmission rate and readmissions spending, suggesting that provider response to bundled incentives may have unintended consequences.
*Data updated since abstract acceptance.
For more information about featured studies, please visit academyhealth.org/arm/pressroom.