Table 2.

Changes in Institutional Post–Acute Care Use Before and After Implementation of Bundled Payment Program, 2013to 2015 vs the Last 3 Quarters in 2016^a

Characteristic	Medicare Advantage			Traditional Medicare
	%		Adjusted Differential Change, % (95% CI)	%		Adjusted Differential Change, % (95% CI)
	Change Among Bundled Payment Hospitals	Change in Control Hospitals		Change Among Bundled Payment Hospitals	Change in Control Hospitals
Any institutional post–acute care	−9.6	−7.4	−2.1 (−4.0 to −0.2)	−10.9	−8.9	−2.3 (−3.9 to −0.7)
Skilled nursing facility	−7.9	−6.3	−1.4 (−3.3 to 0.5)	−7.2	−6.8	−0.7 (−2.3 to 0.8)
Inpatient rehabilitation	−1.7	−0.8	−1.0 (−2.1 to 0.2)	−3.2	−1.8	−1.4 (−2.3 to −0.5)
Long-term care hospital	−0.1	−0.1	0 (−0.1 to 0.2)	0	−0.1	0.1 (0 to 0.1)
Other	0	−0.2	0.2 (0 to 0.4)	−0.5	−0.3	−0.3 (−0.9 to 0.4)

^aThe change among bundled payment hospitals and change in control hospitals columns show the changes in unadjusted average institutional post–acute care use (weighted) between the preperiod (2013–2015) and the postperiod (April 2016-December 2017). Differential changes were adjusted by hospital and quarter fixed effects, procedure characteristics (diagnosis-associated group, fracture, and procedure type), patient characteristics, including indicators for age group (<65, 65–69 y, 70–74, 75–79, 80–84, and $85 years), male, race/ethnicity (white, black, Asian, other, and Hispanic), metro residence, entitlement reason (age, disability, and end-stage renal disease), Medicaid enrollment in prior 12 months, and 19 comorbidity indicators (condition categories) used by Medicare’s readmission program for risk adjustment. Metropolitan statistical area sample weights were used and are described in Barnett et al⁴ and errors were clustered at the metropolitan statistical area level.