Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Healthcare Bundled Payments

Medicare Cardiac, Ortho Bundled Payments Delayed Until 2018

May 23, 2017 - CMS recently delayed the launch date of three mandatory Medicare cardiac and orthopedic bundled payment models and the Cardiac Rehabilitation Incentive Payment program from May 20, 2017, to Jan. 1, 2018. The final ruling from the federal agency will impact the Episode Payment Models, which target 90-day care episodes for acute myocardial infarctions, coronary artery bypass grafts, and surgical...


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Medicare Cardiac, Ortho Bundled Payments Delayed Until 2018

by Jacqueline Belliveau

CMS recently delayed the launch date of three mandatory Medicare cardiac and orthopedic bundled payment models and the Cardiac Rehabilitation Incentive Payment program from May 20, 2017, to Jan. 1, 2018. The final ruling from the federal agency...

Post-Acute Care Costs by Market Affect Bundled Payment Models

by Jacqueline Belliveau

A recent study in Medical Care found that post-acute care variations by healthcare market significantly impacted total episode costs in 30-day hip and knee replacement bundled payment models, suggesting financial strategies should focus on high-utilizers...

Bundled Payments, Clinical Pathways Drive Cancer Care Savings

by Jacqueline Belliveau

Early adopters of value-based reimbursement models for oncology realized significant cancer care savings through bundled payments and clinical pathways, a recent Evidence-Based Oncology study revealed. But the financial incentives for the models...

NAACOS: Mandatory Bundled Payments Impede ACO Financial Success

by Jacqueline Belliveau

The National Association of ACOs (NAACOS) recently urged CMS to indefinitely suspend upcoming mandatory Medicare bundled payment models until the federal agency resolves financial conflicts between the episodic arrangements and accountable care...

AHA Backs Cardiac, Ortho Bundled Payments Delay Until 2018

by Jacqueline Belliveau

The American Hospital Association (AHA) recently supported a CMS proposal to further delay Medicare bundled payments for cardiac and orthopedic care episodes to Jan. 2018. The Advancing Care Coordination through Episode Payment Models postponement...

Keep Medicare Bundled Payment Models Mandatory, Experts Say

by Jacqueline Belliveau

Switching Medicare bundled payment models that are currently mandatory in select regions to voluntary across the country would impede value-based reimbursement progress through episodic payment, industry experts warned the Trump administration...

Bundled Payment Models Here to Stay Despite CMS Program Delays

by Jacqueline Belliveau

CMS may have issued three-month delays for several new healthcare bundled payment models, but providers should still anticipate the shift to value-based purchasing through the episodic alternative payment model, said Colin Luke, a partner at...

Using Bundled Payments to Pay Providers for mHealth Nudges

by Jacqueline Belliveau

Many providers have been able to extend their reach outside of their office by using mHealth technologies that encourage patients to improve their own health outcomes through nudges. However, payment structures for the healthcare encounters have...

Premier: Bundled Payment Models Should be Voluntary Nationwide

by Jacqueline Belliveau

Premier Healthcare Alliance recently offered CMS several recommendations for bundled payment model development, including making programs voluntary for providers across the nation. CMS has implemented several mandatory bundled payment models...

Transradial, Same Day Discharge Cardiac Care Drops Costs by $3.7K

by Jacqueline Belliveau

From acute myocardial infarctions to coronary artery bypass grafts initiatives, recent Medicare bundled payment models have providers focusing more on reducing healthcare costs and improving care quality for a range of cardiac care episodes....

Key Considerations for Bundled Payment Model Adoption, Success

by Jacqueline Belliveau

As the value-based reimbursement transition pushes on, many provider organizations have turned to bundled payment models as a stepping stone to alternative payment model adoption. “Bundled payments can be an organization’s first step...

CMS Unveils New Medicare APMs for Quality Payment Program

by Jacqueline Belliveau

CMS finalized several new Medicare alternative payment models that will qualify for a five percent value-based incentive payment through the Quality Payment Program. The announcement contained bundled payment initiatives for cardiac and orthopedic...

Potential Challenges, Benefits of the Cardiac Bundled Payment

by Jacqueline Belliveau

Earlier this year, CMS proposed a cardiac bundled payment model that would reduce Medicare spending by $170 million on five years, but a new report in the Journal of the American Medical Association identified several potential drawbacks of the...

AMGA Voices Concerns Over Cardiac Care Bundled Payments Model

by Jacqueline Belliveau

With the comment period on a proposed cardiac care bundled payments model closing earlier this week, the American Medical Group Association (AMGA) penned a letter to CMS Acting Administrator Andy Slavitt critiquing the mandatory Medicare demonstration....

Bundled Payments Model Cuts Joint Replacement Costs by $1,166

by Jacqueline Belliveau

Hospitals participating in the Bundled Payments for Care Improvement initiative decreased Medicare spending on lower extremity joint replacement hospitalizations by $1,166 per episode compared to non-participating hospitals, reported a study...

Cardiac Care Bundled Payment Model to Generate Modest Savings

by Jacqueline Belliveau

The recently proposed Medicare bundled payment model for cardiac care will likely bring only modest shared savings or losses to participants, according to a study from Avalere Health. About 85 percent of providers that will be required to take...

New Rules for Bundled Payment Models for Cardiac, Hip Care

by Jacqueline Belliveau

CMS has proposed to develop bundled payment models for cardiac care and hip surgeries that would qualify for financial incentives in the proposed Quality Payment Program in MACRA, according to a recent announcement. “On July 25, 2016, the...

Understanding the Basics of Bundled Payments in Healthcare

by Jacqueline Belliveau

The shift to value-based care has driven public and private payers to redesign reimbursement models that stress accountability for care quality and healthcare costs. As the fee-for-service environment fades away, alternative payment models like...

Finding a Place for Bundled Payments in MACRA Implementation

by Jacqueline Belliveau

As officials at the Centers for Medicare and Medicaid Services (CMS) sift through over 3,800 comments on the proposed rule for MACRA implementation, the Healthcare Incentives Improvement Institute (HCI3) has released its comment letter to CMS...

Industry Group Advises HHS to Expand Bundled Payment Models

by Jacqueline Belliveau

The Center for American Progress (CAP), a Washington think tank, has called on the federal government to expand bundled payment models in order to further reduce healthcare costs and advance value-based care. The letter to Department of...

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