Award Date
12-15-2019
Degree Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Health Care Administration and Policy
First Committee Member
Jay Shen
Second Committee Member
Christopher Cochran
Third Committee Member
Josue Epane
Fourth Committee Member
Shawn McCoy
Fifth Committee Member
Ian McDonough
Number of Pages
171
Abstract
This study investigates the potential impact of the Bundled Payments for Care Improvement (BPCI) initiative from Center for Medicare and Medicaid Services on hospital performance and behavior related to effectiveness and efficiency. The BPCI is under the Affordable Care Act and provides hospitals with a fixed amount of reimbursement for a total episode of care. Building on the agency theory, I argue that the BPCI initiative has the potential to enhance the effectiveness and efficiency of hospital care. This quasi-experimental study examines the changes in hospital care outcomes of patients with replacement of the lower extremity or sepsis in BPCIparticipating hospitals and their counterparts in non-participating hospitals. Based on the 2013– 2017 inpatient discharge data of Nevada, I apply the difference-in-differences modeling to evaluate hospital care outcomes before and after BPCI initiative implementation. The study produced mixed findings, with positive changes supporting my theoretical predictions and hypotheses in the case of sepsis, but no changes detected in support for my theoretical predictions and hypotheses for major joint replacement of the lower extremity.
Keywords
alternative payment model; BPCI initiative; bundled payment; medicare; sepsis; total joint replacement
Disciplines
Health and Medical Administration
File Format
File Size
0.101 MB
Degree Grantor
University of Nevada, Las Vegas
Language
English
Repository Citation
Kim, Pearl, "Effect of Bundled Payments as a Care Improvement Initiative on Hospital Care of Total Joint and Sepsis: A Perspective on Organizational Effectiveness" (2019). UNLV Theses, Dissertations, Professional Papers, and Capstones. 3816.
http://dx.doi.org/10.34917/18608693
Rights
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