Once advantage of working with many clients is the diversity of situations that you get to see. So when we got a call that a client wanted to discuss the merits of the various selections of risk tracks under the Medicare BPCI bundled payment initiative, we gathered the team together for a conference call.
At the recent Becker’s Hospital Review Annual Meeting in Chicago, several presentations covered accountable care organizations, bundled payments and other new payment methodologies. Although not described specifically in these presentations, two different payment arrangements are emerging in which payers and providers are cooperating to reduce healthcare costs. This article compares and contrasts those payment methodologies.
At the recent Becker's Hospital Review Annual Meeting, Jon Pearce from Singletrack Analytics and Kelly Price from DataGen presented a session on "Leveraging Lessons Learned from Medicare's Bundled Payment Program".
Assessing savings opportunities in the Medicare bundled payment initiative
The Medicare Bundled Payment for Care Improvement (BPCI) initiative provides opportunities for participants to create financial advantages in several ways. This article describes the categories of these opportunities, the differences in strategies for approaching the opportunities, and some limitations on their potential for success.
This article was originally written in November, 2012 when the concept of outliers was initially proposed by CMS. Portions of the article were updated in June, 2013 after the proposal for multiple outlier limits were released.
One of the changes implemented by CMS in this round of the bundled payment application project is the introduction of outlier limits on episode costs. The original CMS proposal was for one set of outliers established at fifth and 95th percentiles of episode costs, but the current proposal establishes three outlier options: