Placement: Brigham and Women’s Hospital
Mentor: Joel Weissman, Ph.D. (Deputy Director and Chief Scientific Officer, Center for Surgery and Public Health, Brigham and Women’s Hospital)
Co-Mentor: Christopher Tompkins, Ph.D., M.M.H.S. (Associate Professor, The Heller School for Management and Policy, Brandeis University)
Project: The Impact of Bundled Payments on the Planning and Delivery of Post-Acute Care
William Wynn-Jones, M.B.B.S., M.Sc., FRCA, MRCP, is a 2017-18 U.K. Harkness Fellow in Health Care Policy and Practice. He most recently completed a healthcare management fellowship with HCA Healthcare UK, where he served as the Specialist Advisor to the Chief Medical Officer. At HCA, Wynn-Jones received an HCA innovation award and was shortlisted for an HSJ Rising Star Award for his work in developing a new healthcare management training program and his research into cost prediction in cardiac surgery. He is currently a senior anesthetic registrar in North West London, and has a strong interest in obstetric anesthesia and perioperative medicine. As a junior registrar, Wynn-Jones initiated and led an infant nutrition health-marketing project with Best Beginnings, NHS London and the Department of Health. He was previously a clinical fellow on the National Medical Director’s Fellowship under Sir Bruce Keogh and was based at the Association of British Healthcare Industries. He has since undertaken fellowships in the medical device industry exploring device design, evaluation and pricing. He holds a Master’s degree in Health Economics, Policy and Management from the London School of Economics and he completed his Medical Degree at King’s College London. He is a member of the Royal College of Physicians and a fellow of the Royal College of Anaesthetists.
Project Abstract: Promoting ‘cross-continuum integration’ and ‘shared accountability for clinical outcomes’ was a particular focus of the Patient Protection and Affordable Care Act. Since its passage, CMS has led demonstrations of mandatory bundled payment schemes, which aim to tie post-acute care to the reference procedure and promote temporal awareness throughout the patient pathway. This project seeks to assess the role of reimbursement reform, in the form of bundled payments, on the provision and organization of post-acute care for common care pathways.
Three themes will be explored: 1) the preexisting variation that exists within post-acute care for unbundled patient pathways; 2) the data landscape that could be used to improve the coordination of care under bundled payments; and 3) the behavior of providers with respect to the organization of post-acute care with the introduction of bundled payments. The quantitative element of this work will be conducted using TRICARE data from the U.S. Department of Defense Military Health System. Site visits and case studies will be used to evaluate the provider level behavioral changes associated with the introduction of the mandatory bundle payment demonstrations.