Bundled payment for actinic keratosis management: Pilot evaluation of developed models - 11/02/19
, Colleen F. Silva, MD b, Sara B. Ferguson, MD c, David Shupp, MD c, James G. Marks, MD a, Jeffrey J. Miller, MD, MBA aAbstract |
Background |
There is an opportunity to explore alternate payment models in dermatology.
Objective |
To pilot 2 bundled payment models for actinic keratosis (AK) management.
Methods |
A prospective cohort study was conducted during September 2013-June 2016. Consecutive patients were recruited from clinics of 5 dermatologists. Patients had to be adults, have ≥1 year of care at the department, and have a history of AK. A bundled payment strategy was prospectively piloted for 1 year and compared with costs in the prior year.
Results |
Overall, 400 participants were enrolled, and complete data was collected for 254 participants. During the year of bundled payments, actual total annual spending on claims was $70,557, whereas model 1 and model 2 bundled payment models would have totaled $67,310 and $74,422, respectively, for the patient cohort. Patient satisfaction surveys showed no difference in the quality of care.
Limitations |
Single-center study and limited sample size. International Classification of Diseases 9 and 10 codes were used to identify claims and might be inaccurate. Costs were modeled rather than fully implemented.
Conclusion |
Dermatologists should be aware of bundled payment models. More work is needed to elucidate the optimal formulation of a bundled payment for AK management, including the services covered, time delimitation, and risk stratification factors.
Le texte complet de cet article est disponible en PDF.Key words : actinic keratosis, alternative payment, bundled payment, cost, health care, health economic
Abbreviations used : AK, ICD, SCC, SD
Plan
| Funding sources: Supported in part by a Career Development Award from the Dermatology Foundation (to Dr Kirby) and a grant from the Pennsylvania Department of Health using Tobacco CURE Funds. The Department specifically disclaims responsibility for any analyses, interpretations, or conclusions. |
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| Conflicts of interest: None disclosed. |
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| Reprints not available from the authors. |
Vol 80 - N° 3
P. 679-684 - mars 2019 Retour au numéro
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