Bundled Payments

CMS Accounts for Extreme Situations in CJR Bundled Payments

by Jacqueline LaPointe

CMS updated rules for the Comprehensive Care for Joint Replacement (CJR) bundled payments model to protect participating hospitals from uncontrollable episodes costs incurred during an emergency...

Hospitalization-Based Bundled Payment Models Key to Lowering Costs

by Jacqueline LaPointe

Bundled payment models should center on acute hospitalizations, rather than outpatient care, because hospitalization-based bundles can more effectively impact post-acute care (PAC) spending, industry...

Emory Healthcare, Walmart Team Up for an ACO, Bundled Payments

by Jacqueline LaPointe

Atlanta-based Emory Healthcare recently announced the creation of an accountable care organization (ACO) with retail giant Walmart, known as the Accountable Care Plan. Walmart employees at 55 Walmart,...

Bundled Payments with Drug Costs Threaten Cancer Care Quality

by Jacqueline LaPointe

Oncology bundled payments that include drug costs would negatively impact cancer care, a new report in the Journal of Oncology Practice showed. According to the report done by Milliman, Inc. for the...

Orgs Troubled by Post-Acute Care’s Role in New Bundled Payments

by Jacqueline LaPointe

Long-term and post-acute care provider organizations recently voiced their concerns with the new Bundled Payments for Care Improvement (BPCI) Advanced model’s reduced role of post-acute care...

Large, High-Volume Hospitals Save in CJR Bundled Payments Model

by Jacqueline LaPointe

Larger hospitals with greater knee and hip replacement volumes were more likely to realize cost savings under Medicare’s mandatory lower joint replacement bundled payments model, a new analysis...

72% of Medical Groups Oppose Mandatory Alternative Payment Models

by Jacqueline LaPointe

The mandatory versus voluntary alternative payment model debate continues. This time medical group practices are voicing their opinions in a new MGMA Stat poll that found 72 percent of group leaders...

AHA Calls for Bundled Payments Delay, Reform for BPCI Advanced

by Jacqueline LaPointe

Though supportive of the Bundled Payments for Care Improvement Advanced (BPCI Advanced), the American Hospital Association (AHA) recently urged CMS to delay the model’s application deadline until...

Patient Education Boosts Revenue, Quality for Joint Replacements

by Jacqueline LaPointe

Offering interactive patient education pre- and post-total joint replacement surgery is key to improving patient outcomes and generating new revenue, a multi-specialty hospital system in the Twin...

Prehabilitation Lowers Episode Costs Under Bundled Payment Models

by Jacqueline LaPointe

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...

Mandatory Bundled Payments Drive Value-Based Care, Docs Argue

by Jacqueline LaPointe

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...

Exploring the Bundled Payments for Care Improvement Advanced Model

by Jacqueline LaPointe

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...

Voluntary Bundled Payments Launch, HHS Nominee Backs Mandatory APMs

by Jacqueline LaPointe

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...

ACO, Bundled Payments Alignment Key to Success for Both Models

by Jacqueline LaPointe

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...

Key Capabilities for Value-Based Reimbursement Models

by Jacqueline LaPointe

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...

CMS Cancels Mandatory Hip, Cardiac Bundled Payment Models

by Jacqueline LaPointe

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...

PTAC Recommends 2 APMs for Potential MACRA Implementation

by Jacqueline LaPointe

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...

382 Hospitals Earn Initial Reconciliation Payments Under CJR Model

by Jacqueline LaPointe

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...

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...

Readmissions, Post-Acute Care Drive Variation in Bundled Payments

by Jacqueline LaPointe

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...