Structured Abstract

Contents

• Preface
• Acknowledgments
• Technical Expert Panel
• Peer Reviewers
• Executive Summary
• Introduction
  • Background and Objectives for This Systematic Review
  • Key Questions
• Methods
  • Topic Selection
  • Input From Stakeholders
  • Criteria for Inclusion/Exclusion of Studies in This Review
  • Searching for the Evidence: Literature Search Strategies for Identification of Relevant Studies To Answer the Key Questions
  • Data Abstraction and Data Management
  • Assessment of Methodological Quality of Individual Studies
  • Data Synthesis
  • Grading the Evidence for Each Key Question
  • Applicability
• Results
  • Articles Identified
  • U.S. Public Insurance Prospective Payment Systems
  • U.S. Private Sector Single-Setting Bundled Payment Systems
  • International Bundled Payment Systems
  • Bundled Payment Systems Including Multiple Providers/Sites of Care
• Summary and Discussion
  • Key Question 1. Impact of Bundled Payment on Health Care Spending and Quality Measures
  • Key Question 2. Differential Effects by Key Design Features
  • Key Question 3. Differential Effects by Key Contextual Factors
  • Applicability
  • Recommendations for Further Research
  • Limitations
  • Conclusion
• References
• Acronyms
• Appendix A. Summary of Evidence From Reviewed Studies
• Appendix B. Included Studies
• Appendix C. Studies Excluded at Full-Text Review
• Appendix D. Strength of Evidence

Suggested citation:

Hussey PS, Mulcahy AW, Schnyer C, Schneider EC. Bundled Payment: Effects on Health Care Spending and Quality. Closing the Quality Gap: Revisiting the State of the Science. Evidence Report/Technology Assessment No. 208. (Prepared by the RAND Evidence-based Practice Center under Contract No. 290-2007-10062-I.) AHRQ Publication No. 12-E007-EF. Rockville, MD: Agency for Healthcare Research and Quality. August 2012. www.effectivehealthcare.ahrq.gov/reports/final.cfm. DOI: https://doi.org/10.23970/AHRQEPCERTA208.1.

This report is based on research conducted by the RAND Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. HHSA 290-2007-10062-I). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.

This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.

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