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March 2018

Reframing the Value Proposition of Coronary Artery Bypass Graft Bundles

Author Affiliations
  • 1Department of Medicine, University of Washington, Seattle
  • 2Leonard Davis Institute of Health Economics, Wharton School, University of Pennsylvania, Philadelphia
  • 3Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia
  • 4Corporal Michael J. Cresenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania
  • 5Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
JAMA Surg. 2018;153(3):199-200. doi:10.1001/jamasurg.2017.4903

The Coronary Artery Bypass Graft (CABG) Model—designed to take effect in 98 urban health care markets across the United States—exemplifies Medicare’s commitment to promote value-based care through CABG bundles.

The mandatory program would have held over 1100 hospitals accountable for the quality and costs of CABG episodes: hospitals that maintain quality and keep spending below a predefined benchmark are eligible for financial savings, while those whose spending exceeds the benchmark are liable for financial losses. Bundles would be triggered by hospitalization for CABG Medicare severity diagnosis-related groups and encompass 90 days of postacute care.

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