{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T02:11:16Z","timestamp":1740103876562,"version":"3.37.3"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T00:00:00Z","timestamp":1682553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Transcatheter aortic valve replacement (TAVR) is an increasingly used but relatively expensive procedure with substantial associated readmission rates. It is unknown how cost\u2010constrictive payment reform measures, such as Maryland's All Payer Model, impact TAVR utilization given its relative expense. This study investigated the impact of Maryland's All Payer Model on TAVR utilization and readmissions among Maryland Medicare beneficiaries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a quasi\u2010experimental investigation of Maryland Medicare patients undergoing TAVR between 2012 and 2018. New Jersey data were used for comparison. Longitudinal interrupted time series analyses were used to study TAVR utilization and difference\u2010in\u2010differences analyses were used to investigate post\u2010TAVR readmissions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the first year of payment reform (2014), TAVR utilization among\u00a0Maryland Medicare beneficiaries dropped by 8% (95% confidence interval [CI]: \u22129.2% to \u22127.1%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), with no concomitant change in TAVR utilization in New Jersey (0.2%, 95% CI: 0%\u20131%, <jats:italic>p<\/jats:italic>\u2009=\u20090.09). Longitudinally, however, the All Payer Model did not impact TAVR utilization in Maryland compared to New Jersey. Difference\u2010in\u2010differences analyses demonstrated that implementation of the All Payer Model was not associated with significantly greater declines in 30\u2010day post\u2010TAVR readmissions in Maryland versus New Jersey (\u22122.1%; 95% CI: \u22125.2% to 0.9%; <jats:italic>p<\/jats:italic>\u2009=0.1).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Maryland's All Payer Model resulted in an immediate decline in TAVR utilization, likely a result of hospitals adjusting to global budgeting. However, beyond this transition period, this cost\u2010constrictive reform measure did not limit Maryland TAVR utilization. In addition, the All Payer Model did not reduce post\u2010TAVR 30\u2010day readmissions. These findings may help inform expansion of globally budgeted healthcare payment structures.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30670","type":"journal-article","created":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T10:18:37Z","timestamp":1682590717000},"page":"1193-1202","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The impact of a statewide payment reform on transcatheter aortic valve replacement (TAVR) utilization and readmissions"],"prefix":"10.1002","volume":"101","author":[{"given":"Pooja S.","family":"Yesantharao","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery Johns Hopkins Hospital Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric W.","family":"Etchill","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Johns Hopkins Hospital Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6593-3985","authenticated-orcid":false,"given":"Alice L.","family":"Zhou","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Johns Hopkins Hospital Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chin Siang","family":"Ong","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Johns Hopkins Hospital Baltimore Maryland USA"},{"name":"Division of Cardiology Johns Hopkins Hospital Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas S.","family":"Metkus","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Johns Hopkins Hospital Baltimore Maryland USA"},{"name":"Division of Cardiology Johns Hopkins Hospital Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph K.","family":"Canner","sequence":"additional","affiliation":[{"name":"Department of Surgery Johns Hopkins Hospital Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diane E.","family":"Alejo","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Johns Hopkins Hospital Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oluseyi","family":"Aliu","sequence":"additional","affiliation":[{"name":"Department of Surgery Johns Hopkins Hospital Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew J.","family":"Czarny","sequence":"additional","affiliation":[{"name":"Division of Cardiology Johns Hopkins Hospital Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rani K.","family":"Hasan","sequence":"additional","affiliation":[{"name":"Division of Cardiology Johns Hopkins Hospital Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jon R.","family":"Resar","sequence":"additional","affiliation":[{"name":"Division of Cardiology Johns Hopkins Hospital Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Schena","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Johns Hopkins Hospital Baltimore Maryland USA"},{"name":"Medical College of Wisconsin Milwaukee Wisconsin 53226 USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,4,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2012.07.002"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.2344"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.1616"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2018.0112"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.7455"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/journalofethics.2015.17.8.pfor1-1508"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.7709"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1314868"},{"key":"e_1_2_8_10_1","unstructured":"Anon.Maryland's All\u2010Payer Model\u2014Achievements Challenges And Next Steps. Project HOPE: The People\u2010to\u2010People Health Foundation Inc. Accessed January 23 \u00a02022.https:\/\/www.healthaffairs.org\/do\/10.1377\/forefront.20170131.058550\/full\/"},{"key":"e_1_2_8_11_1","first-page":"1","volume-title":"Evaluation of the Maryland All\u2010Payer Model: Second Annual Report","author":"Haber S","year":"2017"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.116.004472"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.10.007"},{"key":"e_1_2_8_14_1","unstructured":"QuickFacts: New Jersey. United States Census Bureau. Accessed May 17 \u00a02021.https:\/\/www.census.gov\/quickfacts\/fact\/table\/NJ\/HCN010212"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2015.07.022"},{"key":"e_1_2_8_16_1","unstructured":"BavryAA.\u00a0Placement of Aortic Transcatheter Valves 3\u2014PARTNER 3. 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