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First Do No Harm: An Opinion on Bundled Care for Stroke Patients

Published:October 26, 2018DOI:https://doi.org/10.1016/j.apmr.2018.10.003

      Abstract

      The Center for Medicare and Medicaid Innovation under the Centers for Medicare and Medicaid Services has invited institutions to demonstrate ways to bundle services into a 90-day episode of acute care that will lower costs and hospital re-admission rates. While these goals are laudable, they overlook the need for and value attained in postacute treatment. This article argues for elimination of the diagnosis of stroke from the proposed demonstration project due to misaligned financial incentives that will severely compromise patient outcomes.

      Keywords

      List of abbreviations:

      BPCI (Bundled Payment for Care Improvement), BPCI-A (Bundled Payment for Care Improvement Advanced), CMS (Centers for Medicare and Medicaid Services), LOS (length of stay)
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