Table 5.
Medicare payments before vs. after enrolling in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) compared to Non-ACS-NSQIP matched control hospitals. Pre-enrollment payments represent mean payments over the three years prior to enrollment.
| ACS-NSQIP Hospitals |
Non-ACS- NSQIP Control Hospitals |
Difference in Average Medicare Payments After Enrollment vs. Before in ACS-NSQIP Hospitals (95% CI) |
Difference in Average Medicare Payments in NSQIP Hospitals vs. Non-ACS-NSQIP Control Hospitals After Enrollment (95% CI)* |
|||||
|---|---|---|---|---|---|---|---|---|
| N=217,324 | N=404,663 | N=430,179 | N=1,226,497 | |||||
|
| ||||||||
| Pre-enrollment | Post-enrollment | Post-enrollment | ||||||
|
| ||||||||
| Year 1 | Year 2 | Year 3 | Year 1 | Year 2 | Year 3 | |||
| Total payments, mean | $20,529 | $18,740 | $642 (280,1003) | $879 (377,1382) | $1058 (414,1703) | $166 (−78,410) | $180 (−88,449) | $40 (−268,348) |
|
| ||||||||
| Payments for index admission, mean | $18,746 | $17,168 | $534 (219,848) | $815 (378, 253) | $957 (396,518) | $54 (−163,272) | $123 (−103,349) | −$11 (−278,257) |
|
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|
Payments for readmissions
| ||||||||
| % with readmission | 14.7 | 13.2 | 15.2 | 15.0 | 15.0 | |||
| Payment, mean | $12,124 | $11,889 | −$12 (−497, 473) | −$154 (−738, 431) | −$268 (−897, 360) | $95 (−405,596) | $201 (−339, 740) | $245 (−231, 721) |
|
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|
Payments for outliers
| ||||||||
| % with outlier payment | 6.0 | 5.1 | 7.0 | 7.2 | 7.4 | |||
| Payment, mean | $23,507 | $20,153 | $1625 (215, 3035) | $3391 (1662, 5120) | $2872 (740, 5004) | $454 (−961,1868) | $1459 (−48, 2965) | −$86 (−1666, 1495) |
*
All models are adjusted for patient characteristics, comorbidities, year of surgery, procedure type and hospital characteristics.