When Secretary Price said "people have coverage, but they don't have care," he underscored his commitment to one of the core values of bundled payments: patient-centered care. Dr. Price believes that “patients and doctors should be in control of healthcare”; which is why he does not support mandatory pilot programs.” He understands that providers need flexibility, not dictations, to accommodate the needs of their patients.
Spotlight on Continued Success of Bundled Payments
By Remedy Partners
Remedy CEO Carolyn Magill Cites Bundles as a Catalyst for Systemic Change
The spotlight was on bundled payments this week as CMS delayed the mandatory implementation of bundled payment initiatives for cardiac care and the expansion of the Comprehensive Care for Joint Replacement bundled payment pilot project. The delay, which was consistent with HHS Secretary Tom Price’s known objections to mandatory initiatives, allowed proponents of the Bundled Payment for Care Improvement initiative (BPCI) program, like Remedy Partners CEO Carolyn Magill, to reinforce the program’s success to date.
Magill emphasized the value of engaged participation in Modern Healthcare. Sharing experience from Remedy Partners, which oversees both $5.7 billion in program spending under the CMMI's BPCI initiative and $115 million in its mandatory bundled payment programs, Magill reinforced that providers who choose to participate in bundles are committed to delivery reform.
Bundles will pay a primary role in healthcare reform, she told Becker’s ASC Review, saying “As we move to more value-based care models that encourage efficiency and improvements in care quality, bundled payments will continue to play a central role.".
Remedy CEO Carolyn Magill Advocates for Bundles in Morning Consult
More than 200,000 government and industry leaders rely on Morning Consult's original reporting and morning email briefings to deliver comprehensive coverage of campaigns and Congress as well as the energy, finance, health and tech industries.
On March 1, this prestigious audience read about the value of bundled payments in an opinion piece penned by Remedy CEO Carolyn Magill. In it, she illustrates that “Remedy programs are expected to save the Medicare Trust Fund more than $120 million in 2017 and that is just the beginning.”
Remedy Partners has developed a complete operating system for managing bundled payment programs. Episode Connect is the only enterprise software for BPCI program administration.
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The Medicare program delayed again its mandatory bundled payment models. This announcement, however, does not change CMS's commitment to the Bundled Payments Care Improvement (BPCI) initiative and its successor model in 2018. Specifically, CMS delayed by three months the effective dates of both the mandatory cardiac EPM programs and the expansion of the CJR model. CMS requests comment on delaying until January 2018 these effective dates.
Managing Episodic Length of Stay (ELOS) in skilled nursing facilities (SNFs) is an important strategy to reduce unnecessary costs and improve outcomes during a patient’s episode of care. It is well established that SNF length of stay varies widely between geographic regions and by payer type (fee for service vs. managed Medicare, for example). This variability is perpetuated by a lack of accessible, standardized information about expectations, performance, and outcomes. The SNF Episodic Length of Stay (ELOS) Guidelines seek to address this issue by offering clinical recommendations and data-driven targets for managing SNF length of stay at the bundle level.
What a whirlwind trip to D.C.! Remedy’s Chairman Steve Wiggins and I visited the U.S. Department of Health & Human Services yesterday to share Remedy's experience in the Bundled Payment for Care Improvement initiative. We joined the CMS leaders of the BPCI initiative, who shared similar observations about the path to bundled payment success.
As the nation focuses on the future of healthcare policy, Remedy has been advocating for the robust use of the bundled payment model as a means to improve patient outcomes and reduce healthcare costs.
A significant study published in the JAMA Internal Medicine at the beginning of the year demonstrates how a health system effectively reduced episodic expenditures through bundled payments by 20 percent. Notwithstanding the rising national costs of joint replacements, Baptist Health System (BHS) saved $20 million over seven years with bundled payments.
One of the most important changes spurred by the practice of value-based care is how physicians may adjust the way they practice. Much of the opportunity to improve value lies in removing needless spending during the period following a hospitalization. For patients, this means spending more time recovering at home and less time in facilities. So what do doctors need to do differently to enable a home recovery?
Hospital-based specialists, generalists (e.g., hospitalists), and surgeons participating in bundled payment programs have tremendous influence over the quality and costs of patient care inside the four walls of the hospital. While many interventions also have effects after discharge, others have more limited post-acute impact. All things being equal, physicians should focus their in-hospital efforts on practices that have a positive effect on patients after they leave the hospital. For example, holding goals of care conversations, early mobilization, prompt discontinuation of urinary and central venous catheters, and asking discharge planners "Why not home?" are but a few of many practices that may improve healthcare value during the post-acute period. In the linked article, I describe how practices that represent 'thinking outside the DRG', or outside the inpatient stay, may improve patient care during recovery from a hospitalization.
Remedy recently hosted our 2016 National Innovation Collaborative, the fifth and largest event in the company’s history. The conference, which was held on November 14 -15 in Philadelphia, brought together 337 healthcare professionals from across the nation, representing more than 70 different acute care hospitals, PGPs, SNFs, HHAs, and more for a multi-day celebration of the successes and challenges of bundled payments.
The Health Care Transformation Task Force issued a strong letter to President-elect Trump, Vice President-elect Pence, and Congressional leadership supporting the continuation of public and private efforts to replace fee-for-service payments for healthcare services with value-based alternatives. Remedy Partners is one of the Task Force’s 43 member organizations (both for-profit and not-for-profit) which include six of the nation’s top 15 health systems and four of the top 25 health insurers, as well as leading national organizations representing employers, patients and their families, and the policy community.