By Kelly A. Briganti, Editorial Director, G2 Intelligence
In a pilot project, more than 2,100 providers are increasing their skin in the game of value-based health care reimbursement by taking on financial risk. The Centers for Medicare & Medicaid Services (CMS) Innovation Center announced the Bundled Payments for Care Improvement Initiative in 2011 and began accepting applications for its first phase in 2012. The initiative tests how well bundling payment for episodes of care coordinates care, improves quality and lowers cost.
The initiative includes four models for bundling payment that are structured based on the type of providers involved (hospitals, post-acute, physicians and others) and the services provided. The goal is for the participants to coordinate their efforts to reduce readmissions, duplicative care and complications that all contribute to increased cost. The initiative is being implemented in phases with the second phase involving provider acceptance of risk.
CMS’ announcement regarding the initiative reports that participants, including acute care hospitals, skilled nursing facilities, physicians, long term care hospitals, inpatient rehabilitation facilities and home health agencies will move to a new phase, accepting financial risk for episodes of care. Those participants include 360 organizations having agreements with CMS to join in the Bundled Payments for Care Improvement Initiative and another 1,755 providers who work with those organizations.
“We are excited that thousands of providers in the Bundled Payments for Care Improvement Initiative have joined us in changing the health care system to pay for quality over quantity—spending our dollars more wisely and improving care for Medicare beneficiaries,” said Patrick Conway, M.D., CMS acting principal deputy administrator and chief medical officer, in a statement. “By focusing on outcomes for an episode of care, rather than separate procedures in care delivery, we are incentivizing hospitals, doctors and other providers to work together to provide high quality, coordinated care for patients.”