For hospitals and physician group practices (PGPs) comfortable enough to adopt a “wait and see strategy” towards bundled payments, consider the early results of two awardee conveners in the Centers for Medicare and Medicaid Innovation’s (CMMI), Model 2, Bundle Payments for Care Improvement (BPCI) Initiative.
Physicians are schooled to be data-driven, objective problems solvers. From the early days of medical school, teaching the practice of medicine has involved deductive reasoning, problem solving and using data to help drive our thought-process and make decisions.
Advancements in Patient Engagement technologies are emerging to drive focused improvement within the surgical episode of care. Coordination of Care is driving improved profitability through reduced readmissions and better outcomes. As government mandates on Quality emerge for Provider consideration and reaction, improving Patient Experience and Reported Outcomes will become a primary concern for many Healthcare Executives.
In January, Health & Human Services (HHS) Secretary, Sylvia M. Burwell announced ambitious goals to transition Medicare hospital and physician payments from the fee-for-service structure towards value-based payments. The first goal was to achieve 30% of payments through alternate payment models like ACOs and bundled payments by 2016. Among many programs, one strategy to achieve this target was the Comprehensive Care for Joint Replacement (CJR) Model announced in July.
Prior to the September 8th deadline, CMS received in excess of 300 written comments on the Notice of Proposed Rule Making (NPRM) regarding CMS-5516-P Medicare Program; Comprehensive Care for Joint Replacement Payment Model for Acute Care Hospitals Furnishing Lower Extremity Joint Replacement Services, published in the Federal Register on July 14, 2015.
In a August 19th letter addressed to Andrew M. Slavitt, Acting Administrator, Centers for Medicare & Medicaid Services (CMS), the Medicare Payment Advisory Commission (MedPAC) outlined their support of the proposed mandatory Comprehensive Care for Joint Replacement (CJR) Model.
Rep. Mike Thompson (D-CA) and co-sponsors Rep. Gregg Harper (R-MS), Rep. Diane Black (R-TN), and Rep. Peter Welch (D-VT) announced, on July 7, 2015, the introduction of the Medicare Telehealth Parity Act of 2015, forward-looking, bi-partisan legislation intended to modernize the way Medicare pays for telehealth services.