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Surprising Result: Bundled Payments Saved Money for Outpatient Surgeries

Penn LDI

By Aidan P. Crowley, Amol S. Navathe, and Austin Kilaru for Penn LDI

Medicare will launch a new – and mandatory – bundled payment model, the Transforming Episode Accountability Model (TEAM), in 2026. The model will randomly select hospitals to participate, with episode-based payments for five surgical conditions: lower extremity joint replacement, spinal fusion, hip fracture, coronary artery bypass graft surgery, and major bowel procedures.

Our study was the first to include physician groups in an evaluation of BPCI Advanced. We analyzed the outcomes of over 800,000 Medicare beneficiaries who received joint replacement surgery. We found that surgeries performed by a physician in BPCI Advanced had a 3% reduction in episode spending, while surgeries at a participating hospital had 2% less spending. We also found evidence of synergy – participating surgeons operating at participating hospitals had 4% less spending per episode.

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