CMS: 1,299 providers join new bundled payment initiative
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on October 9 announced that 1,299 healthcare providers are participating in its new Bundled Payments for Care Improvement−Advanced model, which began October 1 and will continue until December 31, 2023. The program includes 32 bundled clinical episodes (29 inpatient, 3…
CMS easing safety-net hospitals’ readmission penalties
Editor's Note The Centers for Medicare and Medicaid Services (CMS), on orders from Congress, is easing its annual readmission penalties on hospitals servicing low-income residents, the September 26 Kaiser Health News reports. The penalties are part of the Affordable Care Act’s effort to encourage better care. The sanctions have been…
For-profit hospitals linked to higher readmission rates
Editor's Note Patients who receive care in for-profit hospitals are more likely to be readmitted than patients in nonprofit public hospitals, this study finds. Using data from 14,307 hospital reports from the national Hospital Readmission Reduction Program for six major diseases, including coronary artery bypass grafting and total hip and…
CMS plans innovative new VBP models
Editor's Note The Centers for Medicare and Medicaid Services (CMS) will be unveiling new payment models centered on high-cost areas as part of ongoing efforts to advance value-based payment (VBP) care, and some models could be mandatory, the September 20 Healthcare Finance News reports. Healthcare providers can expect reduced regulatory…
Orthopedic bundled payment models on the fast track--Part 2
According to a 2016 McKesson report, payers expect value-based reimbursement, including bundled payments, to grow from a third of their business to a majority of it in 5 years. And as noted in Part 1 of this two-part series (OR Manager, September 2018, 1, 13-17), bundles are advancing on multiple…
What are the top challenges for today's ASC leaders?
We asked some top ambulatory surgery center (ASC) leaders, including members of OR Manager’s Editorial Advisory Board, to identify the top challenges ASC leaders are facing. Here are their responses. We believe you will see some of your own challenges reflected in their comments. Mary Stewart, MSN, BSN, RN…
Value-based payment models moving forward
Editor's Note Accountable care organizations (ACOs) and other value-based payment (VBP) models are increasing in the US, and there is no longer any question of whether private payers and the Centers for Medicare and Medicaid Services (CMS) will continue to support value-based payments, according to the August 14 Health Affairs…
Effect of Medicare’s bundled payment program on volume, case mix
Editor's Note Hospital participation in Medicare’s Bundled Payments for Care Improvement (BPCI) program for lower extremity joint replacement (LEJR) was not associated with changes in overall procedural volume or the majority of patient case-mix factors, this study finds. The analysis of 1,717,243 Medicare patients found hospital participation in the BPCI…
First year analysis of CJR bundled payment model
Editor's Note This interim analysis of the first year of the Comprehensive Care for Joint Replacement (CJR) bundled payment model finds that CJR may reduce institutional postacute care. Of 75 metropolitan statistical areas (MSAs) that were assigned the bundled payment model and 121 control MSAs, the mean percentage of discharges…
Orthopedic bundled payment models on the fast track--Part 1
The Centers for Medicare & Medicaid Services (CMS) is poised to launch Bundled Payments for Care Improvement (BPCI) Advanced on October 1, 2018, and is continuing its Comprehensive Care for Joint Replacement (CJR) bundled payment model for total hip and knee arthroplasty (THA, TKA). “Orthopedics is the most important service…
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