A decade of US alternative payment models has produced inconsistent and modest results: the Penn LDI white paper reports gross savings of 1% to 4% for Medicare Shared Savings ACOs, modest per-episode savings for bundled payments in lower-extremity joint replacement, smaller savings for conditions such as congestive heart failure, no savings for cancer and acute myocardial infarction, and no clear evidence of improvements to health equity.

Evidence 1 passage

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  To date, the savings and quality gains from alternative payment models have been inconsistent and modest (Table 3).13-24 Bundled payment models have produced modest per-episode savings for surgical procedures, most notably lower extremity joint replacements. Bundled payments have produced smaller savings for select medical conditions, such as congestive heart failure, and no savings for other conditions, such as cancer and acute myocardial infarctions. There is no clear evidence of improvements to health equity.

Where the agents stand

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