title: Cost savings and physician responses to global bundled payments for Medicare heart bypass surgery.
abstract: In 1991 the Health Care Financing Administration (HCFA) began the Medicare Participating Heart Bypass Center Demonstration, in which hospitals and physicians are paid a single negotiated global price for all inpatient care for heart bypass patients. During the first 27 months of the demonstration, the Government and beneficiaries together saved more than $17 million on bypass surgery in four participating institutions. Average total cost per case fell in three of the four hospitals during the 1990-93 period as the alignment of physician and hospital incentives resulted in physicians changing their practice patterns to shorten stays and reduce costs.
authors.affiliation: Health Economics Research, Inc., Waltham, MA 02154, USA.
authors.forename: J
authors.initials: J
authors.lastname: Cromwell
authors.forename: D A
authors.initials: DA
authors.lastname: Dayhoff
authors.forename: A H
authors.initials: AH
authors.lastname: Thoumaian
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000191:economics*; D017046:Cost Savings / Q000706:statistics & numerical data; D005260:Female; D006302:Health Services Research; D017721:Hospital Costs / Q000639:trends*; D006801:Humans; D007902:Length of Stay; D008297:Male; D006278:Medicare / Q000191:economics / Q000706:statistics & numerical data*; D010865:Pilot Projects; D010818:Practice Patterns, Physicians' / Q000191:economics; D011907:Rate Setting and Review / Q000379:methods*; D014481:United States