s an alternative payment model, bundled payments hold the potential to improve the value of care by holding clinicians and organizations accountable for episode-specific quality and costs. Medicare has scaled bundled payments nationwide via several programs that define episodes based on hospitalization and up to 90 days of post-acute care. However, the impact of bundled…
Medicare’s bundled payment programs are in an opportune position to produce additional savings and create a more cost-effective public payer program with certain revisions, a new white paper from USC Brookings explains. CMS’s current bundled payment programs would achieve greater cost effectiveness by extending acute hospital reimbursement and hospital-based bundled payment episodes, argued John A….
Value-based care networks are a promising opportunity for payers that want to manage costs and improve outcomes of beneficiaries. But effectively scaling collaborative, risk-based reimbursement networks for millions of beneficiaries requires a great deal of strategy and insight. The BlueCross Blue Shield Association (BCBSA) has successfully scaled its value-based care initiatives through the Blue Distinction…
In health care, all bundled payment models shift financial and clinical accountability to a single provider-led entity that then is responsible for a budget and the quality of care delivered for any given episode. The entity receiving the bundled payment earns a higher margin if a patient has fewer expenditures but also bears the financial…
Atlanta-based Emory Healthcare recently announced the creation of an accountable care organization (ACO) with retail giant Walmart, known as the Accountable Care Plan. Walmart employees at 55 Walmart, Sam’s Club, and Walmart Distribution Center locations in the metro-Atlanta region have been able to enroll in the Accountable Care Plan since Jan. 1, 2018. The employees…
In announcing the forthcoming Bundled Payments for Care Improvement Advanced (BPCI Advanced) program, Medicare has demonstrated its commitment to bundled payments as a value-based alternative payment model (APM). In a prior post, we compared features of the BPCI Advanced to its predecessor program, the Bundled Payments for Care Improvement (BPCI) initiative, and highlighted how certain…