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

Healthcare Bundled Payments

Do Oncology Bundled Payments Promote Low-Value Drug Use?

July 25, 2017 - 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, the oncology group argued that bundled payments incentivize healthcare providers to use low-value medications in order to realize greater savings under...


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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...

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...

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....

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