CMS launched the Bundled Payment for Care Improvement (BCPI) Initiative in 2013 to test innovative payment models and find ways to lower costs for 48 distinct episodes of care. Under the program, hospitals and post-acute providers work together to improve quality and reduce unnecessary utilization. As of January 2017, the initiative has about 1360 participants, including 340 hospitals. The following list contains the top 10 hospitals by lowest episodic costs for heart attack during a two-year period, 2014 to 2016.
The top 10 hospitals tend to have more staffed beds and lower heart attack 30-day readmission and mortality rates than the average hospital. A lower readmission rate is associated with decreased costs, which can be seen in the smaller share of non-anchor (post-original discharge admission) inpatient spending compared to the national average. HHA spending as a percent of total episode costs is also higher at the top 10 facilities, while the proportion of SNF spending is lower for most hospitals, which also helps explain the cost savings. Another characteristic shared by the top 10 hospitals is that they are all part of sizeable IDNs, such as Centura Health, Sentara Healthcare, and IASIS Healthcare. Effective care coordination requires a significant investment, and larger IDNs generally have the resources necessary to hire care coordinators, integrate IT systems, and manage population health programs.