PDF(Pubmed)
Abstract：
UNASSIGNED: Heart failure (HF) is among the leading causes of death in the United States. Further, patients hospitalized because of HF with comorbid diabetes mellitus (DM) are at a significantly increased risk of death and rehospitalization. Results from the SOLOIST-WHF trial show that sotagliflozin lowered rates of readmission among hospitalized patients with HF and comorbid DM. However, it is unclear what the economic impact of the use of sotagliflozin would be on hospitals and health systems, particularly in an age where provider reimbursement is increasingly tied to value.
UNASSIGNED: To quantify the 1-year financial impact on US provider health systems of adopting sotagliflozin relative to standard of care (SoC) across different alternative payment models.
UNASSIGNED: This study created a 3-part decision tree model to quantify the financial impact of using sotagliflozin to treat patients hospitalized with HF in a US hospital setting. The model first estimated the clinical and economic outcomes of health systems with current SoC (no sotagliflozin) to treat US patients hospitalized for HF with comorbid DM. Then, using the results from the SOLOIST trial, the changes in clinical and economic outcomes with sotagliflozin adoption were modeled. Finally, the differences in health care utilization between sotagliflozin and SoC arms were translated to differences in health system reimbursement in the context of 3 common alternative payment models (APMs) in addition to the baseline fee-for-service (FFS) model: FFS with the Hospital Readmissions Reduction Program, the Bundled Payments for Care Improvement-Advanced program, and Accountable Care Organizations.
UNASSIGNED: A typical community hospital would have 83.4 patients per year on average with an index HF hospitalization with comorbid DM. The model predicted that sotagliflozin would reduce the probability of hospitalization, emergency department visits, and deaths by 29.3%, 38.5%, and 17.8%, respectively, compared with SoC. For hospitals not participating in APM programs, sotagliflozin resulted in a net loss of $92.94 per person ($7,754 per health system). Conversely, when accounting for provider health system participation in APMs, sotagliflozin adoption increased financial returns by $4,720 per person ($305,604 per health system) under the Hospital Readmissions Reduction Program, $1,200 per person ($100,106 per health system) for the Bundled Payments for Care Improvement-Advanced program, and $1,078 per person ($31,029 per health system) for Accountable Care Organizations. Based on the national average composition of APM reimbursement, sotagliflozin adoption resulted in a $1,576 increase in margin per patient with HF ($105,454 per health system).
UNASSIGNED: Although sotagliflozin adoption reduced health system revenue in an FFS payment model, it led to a net positive financial impact after accounting for APM bonus payments.
UNASSIGNED: To quantify the 1-year financial impact on US provider health systems of adopting sotagliflozin relative to standard of care (SoC) across different alternative payment models.
UNASSIGNED: This study created a 3-part decision tree model to quantify the financial impact of using sotagliflozin to treat patients hospitalized with HF in a US hospital setting. The model first estimated the clinical and economic outcomes of health systems with current SoC (no sotagliflozin) to treat US patients hospitalized for HF with comorbid DM. Then, using the results from the SOLOIST trial, the changes in clinical and economic outcomes with sotagliflozin adoption were modeled. Finally, the differences in health care utilization between sotagliflozin and SoC arms were translated to differences in health system reimbursement in the context of 3 common alternative payment models (APMs) in addition to the baseline fee-for-service (FFS) model: FFS with the Hospital Readmissions Reduction Program, the Bundled Payments for Care Improvement-Advanced program, and Accountable Care Organizations.
UNASSIGNED: A typical community hospital would have 83.4 patients per year on average with an index HF hospitalization with comorbid DM. The model predicted that sotagliflozin would reduce the probability of hospitalization, emergency department visits, and deaths by 29.3%, 38.5%, and 17.8%, respectively, compared with SoC. For hospitals not participating in APM programs, sotagliflozin resulted in a net loss of $92.94 per person ($7,754 per health system). Conversely, when accounting for provider health system participation in APMs, sotagliflozin adoption increased financial returns by $4,720 per person ($305,604 per health system) under the Hospital Readmissions Reduction Program, $1,200 per person ($100,106 per health system) for the Bundled Payments for Care Improvement-Advanced program, and $1,078 per person ($31,029 per health system) for Accountable Care Organizations. Based on the national average composition of APM reimbursement, sotagliflozin adoption resulted in a $1,576 increase in margin per patient with HF ($105,454 per health system).
UNASSIGNED: Although sotagliflozin adoption reduced health system revenue in an FFS payment model, it led to a net positive financial impact after accounting for APM bonus payments.
摘要：
心力衰竭（HF）是美国主要的死亡原因之一。Further,因HF合并糖尿病(DM)而住院的患者死亡和再住院风险显著增加.SOLOIST-WHF试验的结果表明，sotagliflozin降低了HF和DM合并症住院患者的再入院率。然而,目前还不清楚使用sotagliflozin会对医院和卫生系统产生什么经济影响，特别是在提供者报销越来越与价值挂钩的时代。
■量化在不同替代支付模式中采用sotagliflozin相对于护理标准（SoC）对美国提供者卫生系统的1年财务影响。
■本研究创建了一个由3部分组成的决策树模型，以量化在美国医院环境中使用sotagliflozin治疗HF住院患者的财务影响。该模型首先评估了使用当前SoC（没有sotagliflozin）治疗因合并DM的HF住院的美国患者的卫生系统的临床和经济结果。然后，使用SOLOIST试验的结果，对服用索格列净后的临床和经济结局的变化进行了建模.最后,sotagliflozin和SoC部门之间的医疗保健利用率差异被转化为除了基线服务费用(FFS)模式之外的3种常见替代支付模式(APM)的卫生系统报销差异：FFS与医院再入院减少计划，护理改善-高级计划的捆绑付款，和负责的护理组织。
■典型的社区医院平均每年有83.4名患者，其中HF住院指数为DM合并症。该模型预测索格列净将降低住院概率，急诊部门的访问，死亡人数占29.3%,38.5%,和17.8%，分别,与SoC相比。对于未参与APM计划的医院，sotagliflozin导致每人净亏损92.94美元（每个卫生系统7,754美元）。相反，当考虑提供者卫生系统参与APM时，根据减少医院再入院计划，采用sotagliflozin使每人的财务回报增加了4,720美元（每个卫生系统为305,604美元），每人1200美元(每个卫生系统100106美元)用于护理改善-高级计划的捆绑支付，负责的护理组织每人$1,078（每个卫生系统$31,029）。根据APM报销的全国平均构成，sotagliflozin的采用导致每位HF患者的利润增加1,576美元（每个卫生系统105,454美元）。
■尽管采用sotagliflozin降低了FFS支付模式下的卫生系统收入，在计入APM奖金支付后，这导致了净积极的财务影响。
■量化在不同替代支付模式中采用sotagliflozin相对于护理标准（SoC）对美国提供者卫生系统的1年财务影响。
■本研究创建了一个由3部分组成的决策树模型，以量化在美国医院环境中使用sotagliflozin治疗HF住院患者的财务影响。该模型首先评估了使用当前SoC（没有sotagliflozin）治疗因合并DM的HF住院的美国患者的卫生系统的临床和经济结果。然后，使用SOLOIST试验的结果，对服用索格列净后的临床和经济结局的变化进行了建模.最后,sotagliflozin和SoC部门之间的医疗保健利用率差异被转化为除了基线服务费用(FFS)模式之外的3种常见替代支付模式(APM)的卫生系统报销差异：FFS与医院再入院减少计划，护理改善-高级计划的捆绑付款，和负责的护理组织。
■典型的社区医院平均每年有83.4名患者，其中HF住院指数为DM合并症。该模型预测索格列净将降低住院概率，急诊部门的访问，死亡人数占29.3%,38.5%,和17.8%，分别,与SoC相比。对于未参与APM计划的医院，sotagliflozin导致每人净亏损92.94美元（每个卫生系统7,754美元）。相反，当考虑提供者卫生系统参与APM时，根据减少医院再入院计划，采用sotagliflozin使每人的财务回报增加了4,720美元（每个卫生系统为305,604美元），每人1200美元(每个卫生系统100106美元)用于护理改善-高级计划的捆绑支付，负责的护理组织每人$1,078（每个卫生系统$31,029）。根据APM报销的全国平均构成，sotagliflozin的采用导致每位HF患者的利润增加1,576美元（每个卫生系统105,454美元）。
■尽管采用sotagliflozin降低了FFS支付模式下的卫生系统收入，在计入APM奖金支付后，这导致了净积极的财务影响。
