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Improving the Payment System

Our work has focused on two issues. First, how do we improve the valuation process for physician services under the RBRVS system. Second, what has been the impact of new payment models such as bundled payments or global budgets on quality, outcomes, and spending. 

Improving valuation in the RBRVS

  • Mulcahy AW, Wynn B, Burgette L, Mehrotra A. Medicare's step back from global payments--unbundling postoperative care. N Engl J Med. 2015;372(15):1385-7
  • Crespin DJ, Ruder T, Mulcahy AW, Mehrotra A. Variation in estimated surgical procedure times across patient characteristics and surgeon specialty. JAMA surgery. 2022 May 1;157(5).
  • Kranz AM, Mulcahy AW, Ruder T, Lovejoy S, Mehrotra A. Patterns of Postoperative Visits Among Medicare Fee-for-Service Beneficiaries. Ann Surg. 2018 Dec 21. 
  • Burgette LF, Mulcahy AW, Mehrotra A, Ruder T, Wynn BO. Estimating surgical procedure times using anesthesia billing data and operating room records. Health services research. 2017 Feb;52(1):74-92.
  • Mulcahy AW, Merrell K, Mehrotra A. Payment for services rendered: updating Medicare’s valuation of procedures. N Engl J Med. 2020 Jan 23;382(4):303-6.

New payment models

  • Barnett ML, Wilcock A, McWilliams JM, Epstein AM, Joynt Maddox KE, Orav EJ, Grabowski DC, Mehrotra A. Two-Year Evaluation of Mandatory Bundled Payments for Joint Replacement. N Engl J Med. 2019 Jan 17;380(3):252-262.
  • Wilcock AD, Barnett ML, McWilliams JM, Grabowski DC, Mehrotra A. Association Between Medicare’s Mandatory Joint Replacement Bundled Payment Program and Post–Acute Care Use in Medicare Advantage. JAMA surgery. 2020 Jan 1;155(1):82-4.
  • Barnett ML, Mehrotra A, Grabowski DC. Postacute care—the piggy bank for savings in alternative payment models?. N Engl J Med. . 2019 Jul 25;381(4):302.
  • Mehrotra A, Damberg CL, Sorbero ME, Teleki SS. Pay for performance in the hospital setting: what is the state of the evidence?. Am J Med Qual. 2009;24(1):19-28.
  • Roberts ET, McWilliams JM, Hatfield LA, Gerovich S, Chernew ME, Gilstrap LG, Mehrotra A. Changes in Health Care Use Associated With the Introduction of Hospital Global Budgets in Maryland. JAMA Intern Med. 2018;178(2):260-268. PMCID: PMC5838791.
  • Roberts ET, Hatfield LA, McWilliams JM, Chernew ME, Done N, Gerovich S, Gilstrap L, Mehrotra A. Changes In Hospital Utilization Three Years Into Maryland's Global Budget Program For Rural Hospitals. Health Aff (Millwood). 2018;37(4):644-653. PMCID: PMC5993431.
  • Mehrotra A, Hussey P. Including physicians in bundled hospital care payments: time to revisit an old idea?. Jama. 2015 May 19;313(19):1907-8.
  • Wilcock AD, Barnett ML, McWilliams JM, Grabowski DC, Mehrotra A. Hospital Responses to Incentives in Episode-Based Payment for Joint Surgery: A Controlled Population-Based Study. JAMA internal medicine. 2021 Jul 1;181(7):932-40.