The June 2016 issue of Today's Hospitalist, the leading publication for inpatient physicians, extensively quotes Remedy Partners’ Chief Medical Officer Win Whitcomb, MD in How to Succeed with Bundled Payments.
The article notes that Remedy is the largest convener in the BPCI program, which affects close to $13 billion of Medicare spending, and shares Whitcomb’s insights from this experience. Whitcomb points out that a key factor in bundled payments is how much Medicare spends on post-acute care and how variable post-acute costs can be. That figure, he points out, can account for three-quarters of the variation in Medicare spending across the U.S. healthcare system.
“While an anchor admission accounts for 33% of Medicare spending for a 90-day episode, SNF costs account for 22% and readmissions make up 17%," he shares in the article. Bundled payment success relies in part on increasing the frequency with which patients are discharged home.
Whitcomb suggests a set of skills for hospitalists involved in bundled payment programs, including providing palliative care, developing assessment skills to lead decision-making around next site of care, and a what he calls “transitionalist services” which he defines as “anything that bridges the gap between when patients are inpatients and when they're stable and back in the primary care system."