The Affordable Care Act and Bundling Payments
The Patient Protection and Affordable Care Act has caused much change in health care and another change is being encouraged: a Bundling Payments initiative. The Department of Health and Human Services recently announced a new initiative designed to help patients receive improved acute and post care. Physicians, acute care facilities, and other health care providers can now apply to participate in the Bundled Payments for Care Improvement Initiative. CMS is seeking assistance to test and develop four different models of payment bundling. Through this initiative, providers could select conditions to bundle and determine how payments would be distributed among providers.
The belief is that “bundled payments can help align incentives for providers to partner and work closely together across specialties and settings…” (CMS, 8/23/2011).
The CMS Innovation Center http://www.innovations.cms.gov has made available the Request for Application (RFA) for three retrospective models. The application is due November 4, 2011. To apply: http://www.innovations.cms.gov/areas-of-focus/patient-care-models/bundled-payments-for-care-improvement.html
Specific questions can be directed to BundledPayments@cms.hhs.gov
Per CMS, research and prior demonstration projects have shown that using a bundled payment initiative for patients with coronary artery bypass graph surgery saved CMS $42.5 million, roughly 10% of expected costs. The research was conducted at hospitals in Atlanta, Columbus, Ann Arbor, and Boston.
Bundled payments are just one part of a wide-ranging effort to improve healthcare yet reduce the cost of that care. The Accountable Care Organizations are another strategy being encouraged.
These strategies are not new. Many organizations have recognized the fragmentation that occurs in healthcare delivery. Recently, the National Quality Strategy launched a Partnership for Patients uniting physicians, nurses, other healthcare professionals as well as unions, the State and the Federal Government to offer ways to prevent hospital readmissions and improve transition between levels of care. CMS announced an investment intended over $1 billion to help drive these changes. CMS also announced their intent to invest over $50 billion over 10 years in like projects.
It appears that innovative projects to decrease fragmentation in care could be rewarded. If you have ideas, why not apply for the RFA?
To read the Affordable Care Act, go to www.HealthCare.gov/news/factsheets/deliverysystem07272011a.html
Tags: Affordable Care Act (ACA), CMS, Compliance, Home Health, Medicare, OASIS-C
