# Affordability and Efficiency for COMprehensive Post-Acute Stroke Services (COMPASS)

> **NIH AHRQ R01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2021 · $397,185

## Abstract

PROJECT SUMMARY
Stroke is a leading cause of mortality, morbidity, and medical expenditures in the United States. For
those who survive the initial stroke, serious gaps exist in the transition to post-acute care. For example,
25% of stroke patients discharged home without post-acute care are readmitted within 90 days.
Comprehensive post-acute services for stroke survivors require bridging hospital-based acute care with
expanded care teams for rehabilitation, primary care management, access to community resources, and
caregiver support. Our team’s COMprehensive Post-Acute Stroke Services (COMPASS) model of care,
which combines transitional care and early supported discharge services, is being implemented in a
pragmatic cluster randomized trial of 41 NC hospitals. Ultimately, sustainable implementation of
COMPASS will be influenced by the return on investments for health systems and costs for payers. Given
trends in reimbursement policies, the effect of COMPASS on readmissions will likely be the key incentive
for healthcare systems to adopt and sustain such evidence-based post-acute services. The overall goal of
this study is to analyze the business case for both payers and hospital systems for the post-acute
services for stroke included in COMPASS. These outcomes have not been assessed previously in a
randomized control trial. Our study will estimate the cost of implementing COMPASS (Aim 1). We will
also estimate the change in payments in the 90 days after stroke caused by COMPASS for major insurers
in North Carolina (Aim 2). Finally, we will combine these estimates to calculate the return on investment
of COMPASS under alternative payment models (Aim 3). Insurers need evidence of interventions that
can achieve lower cost without sacrificing quality of care. Our study will provide timely evidence of the
economic value of post-acute stroke care and can inform the design of a stroke bundle that ensures
hospitals and payers benefit.

## Key facts

- **NIH application ID:** 10165787
- **Project number:** 5R01HS025723-04
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** CHERYL D BUSHNELL
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2021
- **Award amount:** $397,185
- **Award type:** 5
- **Project period:** 2018-08-01 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10165787

## Citation

> US National Institutes of Health, RePORTER application 10165787, Affordability and Efficiency for COMprehensive Post-Acute Stroke Services (COMPASS) (5R01HS025723-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10165787. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*