{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:09:30Z","timestamp":1777932570756,"version":"3.51.4"},"reference-count":10,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T00:00:00Z","timestamp":1548979200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Population Health Management"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:p>Safety net community hospitals face unique challenges when entering risk-based contracts. The financial viability of such programs in these settings has not been well studied. This study analyzed a bundled-payment program for congestive heart failure at one such facility. To assess financial performance, the authors calculated the net patient payment by quarter after bundle implementation, and also compared the leading cost drivers before and after bundle implementation, specifically the next site of care and readmission rate. After 21 months of participating in the bundle, the program has saved money, been financially feasible, and generated positive returns for the hospital. Admission to skilled nursing facilities decreased from 21.3% to 16.0% after bundle implementation. The readmission rate was not significantly different, but trended downward. This study shows that safety net community hospitals can successfully participate in a bundled-payment program. For heart failure patients, decreasing admission to skilled nursing facilities and lowering the readmission rate are essential for program success.<\/jats:p>","DOI":"10.1089\/pop.2018.0001","type":"journal-article","created":{"date-parts":[[2018,5,29]],"date-time":"2018-05-29T16:50:06Z","timestamp":1527612606000},"page":"12-18","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Effect of Implementing a Bundled-Payment Program for Heart Failure at a Safety-Net Community Hospital"],"prefix":"10.1177","volume":"22","author":[{"given":"Jonathan","family":"Lichkus","sequence":"first","affiliation":[{"name":"Greater Lawrence Family Health Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Wolf","sequence":"additional","affiliation":[{"name":"Lawrence General Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robin","family":"Hynds","sequence":"additional","affiliation":[{"name":"Lawrence General Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerry","family":"Moorer","sequence":"additional","affiliation":[{"name":"Amedisys Home Health and Hospice Care"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Derek","family":"Bourgoine","sequence":"additional","affiliation":[{"name":"Lawrence General Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Garabedian","sequence":"additional","affiliation":[{"name":"Lawrence General Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pracha","family":"Eamranond","sequence":"additional","affiliation":[{"name":"Lawrence General Hospital"},{"name":"Brigham and Women's Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,2,4]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"American Hospital Association. Medicare DSH (Fact sheet). Washington DC: American Hospital Association 2015."},{"key":"e_1_3_2_3_2","unstructured":"Centers for Medicare & Medicaid Services. Bundled Payments for Care Improvement Initiative. April 18 . 2016. https:\/\/www.cms.gov\/Newsroom\/MediaReleaseDatabase\/Fact-sheets\/2016-Fact-sheets-items\/2016-04-18.html Accessed August1 2017."},{"key":"e_1_3_2_4_2","unstructured":"Porter ME Lee TH. The strategy that will fix health care. October. 2013. https:\/\/hbr.org\/2013\/10\/the-strategy-that-will-fix-health-care Accessed August1 2017."},{"key":"e_1_3_2_5_2","article-title":"Heart disease and stroke statistics\u20142016 update: a report from the American Heart Association","author":"Mozzafarian D","year":"2016","unstructured":"Mozzafarian D, , Benjamin EJ, , Go AS, et al. Heart disease and stroke statistics\u20142016 update: a report from the American Heart Association. Circulation, 2016:133:e38\u2013e360.","journal-title":"Circulation"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31820a55f5"},{"key":"e_1_3_2_7_2","unstructured":"Hines AL Barrett ML Jiang HJ Steiner CA. Conditions with the largest number of adult hospital readmissions by payer 2011. HCUP Statistical Brief #172. Rockville MD: Agency for Healthcare Research and Quality 2014."},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2014.0900"},{"key":"e_1_3_2_9_2","unstructured":"United States Census Bureau. American Fact Finder. August 11 . 2017. https:\/\/factfinder.census.gov\/faces\/nav\/jsf\/pages\/community_facts.xhtml Accessed August12 2017."},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1315607"},{"key":"e_1_3_2_11_2","unstructured":"Centers for Medicare & Medicaid Services. Skilled Nursing Facility PPS. August 1 2017. https:\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-Payment\/SNFPPS Accessed August26 2017."}],"container-title":["Population Health Management"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/pop.2018.0001","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/pop.2018.0001","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/pop.2018.0001","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T01:23:46Z","timestamp":1777685026000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/pop.2018.0001"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1089\/pop.2018.0001"],"URL":"https:\/\/doi.org\/10.1089\/pop.2018.0001","relation":{},"ISSN":["1942-7891","1942-7905"],"issn-type":[{"value":"1942-7891","type":"print"},{"value":"1942-7905","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2]]}}}