Abstract 21019: Do Heart Failure Disease Management Programs Make Financial Sense Under a Bundled Payment System?
Background: Policy makers have proposed to no longer pay for readmissions within thirty days in heart failure (HF) patients. Coordinated, disease management programs have been demonstrated to reduce HF readmissions; yet, whether they can be cost neutral to cost saving under bundled payment strategies has not been explored.
Methods: We created a decision analysis model to evaluate the 30-day costs and outcomes associated with outpatient HF disease management programs. Probabilities for mortality, and readmissions within 30 days were derived from published results. Aggregate costs for HF index hospitalizations and subsequent readmission costs were estimated from Medicare data. Costs for HF disease management programs were estimated from published studies.
Results: The costs of disease management programs as well as their effectiveness to reduce readmission varied widely (Table 1). Despite their costs, most of these programs were cost saving from the hospitals' perspective via avoiding readmission costs.
Conclusions: Proposed bundled payment for HF admissions make disease management programs economically attractive for hospitals, providing them with a net savings per patient.
- © 2010 by American Heart Association, Inc.