Alternative Payment Models and Patient-Reported Quality of Preparation for Discharge: A Retrospective Longitudinal Study
Preparing patients for posthospital care may improve readmission risk. Alternative payment models (APMs) incent hospitals to reduce readmissions by tying payment to outcomes. The impact of APMs on preparation for discharge is not well understood. We assessed whether patient-reported preparation for...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2024-03-01
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| Series: | Journal of Patient Experience |
| Online Access: | https://doi.org/10.1177/23743735241240926 |
| _version_ | 1827311458740862976 |
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| author | Sunny C. Lin PhD MS Julia Adler-Milstein PhD John M. Hollingsworth MD, MS Andrew Ryan PhD |
| author_facet | Sunny C. Lin PhD MS Julia Adler-Milstein PhD John M. Hollingsworth MD, MS Andrew Ryan PhD |
| author_sort | Sunny C. Lin PhD MS |
| collection | DOAJ |
| description | Preparing patients for posthospital care may improve readmission risk. Alternative payment models (APMs) incent hospitals to reduce readmissions by tying payment to outcomes. The impact of APMs on preparation for discharge is not well understood. We assessed whether patient-reported preparation for posthospital care was associated with reduced readmissions, and whether APM participation was associated with improved preparation for posthospital care. We used mixed-effects regression on retrospective (2013–2017) observational data for 2685 U.S. hospitals. We measured patient-reported preparation for posthospital care using the 3-Item Care Transition Measure and readmission using 30-day all-cause risk-adjusted readmissions from Hospital Compare. Participation in accountable care organizations (ACOs), Medical Homes, and Medicare's Bundled Payments for Care Improvement program was obtained from Medicare, the American Hospital Association's Annual Survey, and Leavitt Partner's ACO database. We found that APMs are not associated with improved preparation for posthospital care, even though it was associated with reduced readmissions (Marginal Effect: −0.012 percentage points). This may be because hospitals are not investing in patient engagement. This study has limited insight into causality and reduced generalizability among smaller, rural, and non-teaching hospitals. |
| first_indexed | 2024-04-24T20:19:17Z |
| format | Article |
| id | doaj.art-3444f6b2bc5b4934a4819e9cbb5d9e25 |
| institution | Directory Open Access Journal |
| issn | 2374-3743 |
| language | English |
| last_indexed | 2024-04-24T20:19:17Z |
| publishDate | 2024-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Patient Experience |
| spelling | doaj.art-3444f6b2bc5b4934a4819e9cbb5d9e252024-03-22T09:04:00ZengSAGE PublishingJournal of Patient Experience2374-37432024-03-011110.1177/23743735241240926Alternative Payment Models and Patient-Reported Quality of Preparation for Discharge: A Retrospective Longitudinal StudySunny C. Lin PhD MS0Julia Adler-Milstein PhD1John M. Hollingsworth MD, MS2Andrew Ryan PhD3 . Louis, St Louis, MO, USA , School of Medicine, San Francisco, CA, USA Department of Urology, NorthShore University HealthSystem, Evanston, IL, USA , Providence, RI, USAPreparing patients for posthospital care may improve readmission risk. Alternative payment models (APMs) incent hospitals to reduce readmissions by tying payment to outcomes. The impact of APMs on preparation for discharge is not well understood. We assessed whether patient-reported preparation for posthospital care was associated with reduced readmissions, and whether APM participation was associated with improved preparation for posthospital care. We used mixed-effects regression on retrospective (2013–2017) observational data for 2685 U.S. hospitals. We measured patient-reported preparation for posthospital care using the 3-Item Care Transition Measure and readmission using 30-day all-cause risk-adjusted readmissions from Hospital Compare. Participation in accountable care organizations (ACOs), Medical Homes, and Medicare's Bundled Payments for Care Improvement program was obtained from Medicare, the American Hospital Association's Annual Survey, and Leavitt Partner's ACO database. We found that APMs are not associated with improved preparation for posthospital care, even though it was associated with reduced readmissions (Marginal Effect: −0.012 percentage points). This may be because hospitals are not investing in patient engagement. This study has limited insight into causality and reduced generalizability among smaller, rural, and non-teaching hospitals.https://doi.org/10.1177/23743735241240926 |
| spellingShingle | Sunny C. Lin PhD MS Julia Adler-Milstein PhD John M. Hollingsworth MD, MS Andrew Ryan PhD Alternative Payment Models and Patient-Reported Quality of Preparation for Discharge: A Retrospective Longitudinal Study Journal of Patient Experience |
| title | Alternative Payment Models and Patient-Reported Quality of Preparation for Discharge: A Retrospective Longitudinal Study |
| title_full | Alternative Payment Models and Patient-Reported Quality of Preparation for Discharge: A Retrospective Longitudinal Study |
| title_fullStr | Alternative Payment Models and Patient-Reported Quality of Preparation for Discharge: A Retrospective Longitudinal Study |
| title_full_unstemmed | Alternative Payment Models and Patient-Reported Quality of Preparation for Discharge: A Retrospective Longitudinal Study |
| title_short | Alternative Payment Models and Patient-Reported Quality of Preparation for Discharge: A Retrospective Longitudinal Study |
| title_sort | alternative payment models and patient reported quality of preparation for discharge a retrospective longitudinal study |
| url | https://doi.org/10.1177/23743735241240926 |
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