As the transition to a sleeker, more value-based reimbursement system occurs, healthcare organizations are under pressure to unearth creative ways to drive down costs while still attracting patients and providing quality care.
Hospitals too will soon have the opportunity to establish commercial bundled payments, but with far more complex cases than TJR. A recent article published by Modern Healthcare examines a new Centers for Medicare and Medicaid Services (CMS) proposal that would require a trio of episodes of care to be tested as bundled payments. The intent is to bundle the three episodes – coronary artery bypass grafts, treatment for acute myocardial infarction (heart attack), and treatment for hip or femoral fractures — as encouragement for participating hospitals to take more financial responsibility for the condition of Medicare patients after they are discharged from the hospital.
But transforming these three episodes to mandatory bundled payments could be a challenge for hospitals. The article reports that patients who suffer a hip fracture have a higher mortality risk in the months after the incident, and patients who suffer a heart attack are at a higher risk for another. Also, unlike TJR, the procedures will not be elective, and thus doctors will not have as much control when it comes to timing and planning of them. Furthermore, some hospitals are more experienced and better prepared than others to take on bundled payments, the article said.
Despite the complexities, the article reports positive feedback on the proposal from some providers. It could culminate in superior outcomes for patients, and aside from that, the entire healthcare industry is moving at a high speed toward value-based payment.
The experiment will begin July 1, 2017 in almost 100 randomly selected areas around the country. Overall, CMS hopes transforming the way hospitals are paid by Medicare to treat these conditions will decrease occurrences and drive down costs. According to the article, about 735,000 people in the U.S. suffer a heart attack every year, and for over 200,000 of them, it is not their first heart attack.
“Transitioning these episodes to bundled payments makes sense for many reasons, but primarily clinically and economically,” says Regent Surgical Health CEO Chris Bishop. “Bundles are a critical part of value-based care, and our organization has made a commitment to be at the forefront of these outpatient bundles.”
Regent Surgical Health offers a strong model of partnership for its hospitals, and can help build a successful game plan for bundled payments. Regent’s leadership team can assist with strategies for the implementation of bundles, so that partner hospitals can be in the best possible position to lower costs and improve patient care.
“As value-based care continues to permeate the industry, it is now more important than ever for providers to have the spark of ingenuity,” said Bishop. “Bundled payments have the potential to keep patients healthy after they leave the hospital, and to save money on costs.”
To read more about Regent Surgical Health’s hospital partners, click here.
