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

Bundled Payments

Prehabilitation Lowers Episode Costs Under Bundled Payment Models

February 6, 2018 - Dedicating even a couple hours to helping patients understand and prepare for a procedure prior to surgery can save providers millions under bundled payment models, explained healthcare industry expert and former CMS official Charlene Frizzera. Bundled payment models traditionally pay providers a fixed amount for a triggering event, such as a joint replacement surgery, and a specified amount...


More Articles

Mandatory Bundled Payments Drive Value-Based Care, Docs Argue

by Jacqueline Belliveau

The recent decision from CMS to cancel two mandatory bundled payments programs slated to launch in 2018 was a “step in the wrong direction for pursuing a healthcare system that focuses on value and not volume,” three physicians argued...

Exploring the Bundled Payments for Care Improvement Advanced Model

by Jacqueline Belliveau

CMS recently unveiled the Bundled Payments for Care Improvement (BPCI) Advanced initiative, a new bundled payments model that will include inpatient and outpatient clinical episodes and qualify as an Advanced Alternative Payment Model (APM) under...

Voluntary Bundled Payments Launch, HHS Nominee Backs Mandatory APMs

by Jacqueline Belliveau

CMS announced a new voluntary bundled payments opportunity starting in late 2018 on the same day that HHS Secretary nominee Alex Azar seemingly backed mandatory alternative payment models during a Senate Finance committee hearing. The new voluntary...

ACO, Bundled Payments Alignment Key to Success for Both Models

by Jacqueline Belliveau

CMS should align accountable care organizations (ACOs) and bundled payments by creating a blended accountability structure that allows organizations to participate in both alternative payment models without financial conflicts, industry experts...

Key Capabilities for Value-Based Reimbursement Models

by Jacqueline Belliveau

Rising healthcare costs, shrinking reimbursement rates, and federal policies are driving hospitals and health systems to adopt value-based reimbursement, according to a new American Hospital Association (AHA) report. But the models are not one-size-fits-all...

CMS Cancels Mandatory Hip, Cardiac Bundled Payment Models

by Jacqueline Belliveau

CMS recently finalized proposals to eliminate mandatory hip fracture and cardiac bundled payment models slated to launch on Jan. 1, 2018 and decrease the scope of the existing Comprehensive Care for Joint Replacement (CJR) bundled payment initiative....

PTAC Recommends 2 APMs for Potential MACRA Implementation

by Jacqueline Belliveau

The Physician-Focused Payment Model Technical Advisory Committee (PTAC) recently recommended two alternative payment models to HHS for possible MACRA implementation. Stakeholders have submitted 19 alternative payment model proposals since the...

382 Hospitals Earn Initial Reconciliation Payments Under CJR Model

by Jacqueline Belliveau

Out of approximately 800 hospitals required to participate in Medicare’s Comprehensive Joint Replacement (CJR) model, 382 facilities will receive a reconciliation payment based on cost savings and care quality, according to preliminary...

AHA Supports Bundled Payment Cancellation, Voices MACRA Concerns

by Kyle Murphy, PhD

Despite back the decision by CMS to cancel two bundled payment models and modify another, the American Hospital Association contends that the federal agency is moving a bit too quickly in shifting providers to value-based payment. According to...

Readmissions, Post-Acute Care Drive Variation in Bundled Payments

by Jacqueline Belliveau

Hospital readmissions, professional fees, and post-acute care payments are key drivers of cost variations for providers participating in 90-day cardiac bundled payment models, a recent JAMA Surgery study revealed. “These results underscore...

Private Sector to Drive Bundled Payments After CMS Cancellations

by Jacqueline Belliveau

CMS recently announced its intention to modify its bundled payments strategy by proposing to eliminate forthcoming mandatory cardiac models and decreasing the scope of the Comprehensive Care for Joint Replacement (CJR) program. The pull away...

CMS May Cancel Upcoming Cardiac, Ortho Bundled Payment Models

by Jacqueline Belliveau

UPDATE: CMS released the complete proposed rule, which would cancel the Episode Payment Models and the Cardiac Rehabilitation Incentive Payment Model. The proposed rule would also decrease the number of mandatory geographic regions in the Comprehensive...

Do Oncology Bundled Payments Promote Low-Value Drug Use?

by Jacqueline Belliveau

Oncology bundled payments are not the answer to lowering prescription drug costs for cancer care delivery, the American Society of Clinical Oncology recently contended. In a position statement on addressing the affordability of cancer drugs,...

3 Challenges Providers Face with Healthcare Bundled Payments

by Jacqueline Belliveau

Healthcare bundled payments are becoming one of the most popular alternative payment models available to providers. Providers are drawn to the episode-based structure’s ability to decrease healthcare costs while maintaining or improving...

Understanding the Top 10 Terms of Value-Based Purchasing

by Jacqueline Belliveau

Whether providers favor it or not, the healthcare industry is inevitability moving to value-based purchasing. CMS reported in 2016 that Medicare already linked 30 percent of traditional fee-for-service payments to value-based purchasing models...

Bundled Payments Rely on Robust Networks, Healthcare Markets

by Jacqueline Belliveau

Healthcare providers are finding that it takes a village to succeed in bundled payment models. From primary care to specialists and post-acute care, providers need an integrated network of provider types and to play to their healthcare market...

Oncology Care Model Overcomes Specialty Bundled Payment Hurdles

by Jacqueline Belliveau

Episode-based payment models aim to shift financial accountability to providers for furnishing services for specific conditions or procedures. But develop specialty bundled payment models that target clinical areas, such as oncology, have proven...

Patient Engagement Critical to Bundled Payment Model Success

by Jacqueline Belliveau

Under bundled payment models, healthcare providers take on the clinical and financial risk payers traditionally managed. But providers at OrthoCarolina found that patients also play a major role in improving care quality and decreasing healthcare...

Incorporating Population Health in Next Gen of Bundled Payments

by Jacqueline Belliveau

The next generation of bundled payments should focus on population health management, researchers recently argued in a Journal of the American Medical Association report. Bundled payment models can align with population health management by extending...

X

Join 30,000 of your peers and get free access to all webcasts and exclusive content

Sign up for our free newsletter:

Our privacy policy

no, thanks

Continue to site...