Remedy Partners executives will be featured in three sessions during The Seventh National Bundled Payment Summit, a leading forum on healthcare payment reforms, to be held on June 26- 28, 2017 in Arlington, VA.
HealthEdge And Remedy Partners Launch Bundled Payments Initiative
Offering Enables Health Plans, TPAs, Self-Funded Plans and State Medicaid Plans to Administer Episode of Care Benefit Plan Designs
BURLINGTON, Mass.--(BUSINESS WIRE)--HealthEdge®, provider of the only integrated financial, administrative and clinical platform for health insurers, and Remedy Partners, the nation’s leading bundled payment company, today announced a collaboration to deliver a transformational platform to the market, capable of administering an entirely new category of health insurance benefit plan based on episodes of care and bundled payments.
This innovative offering provides a turnkey opportunity for payers, large self-funded employers and third party administrators to underwrite, sell, and/or administer episodes of care-based commercial products. The platform may be offered as a part of a comprehensive business process outsourcing (BPO) package or as a standalone platform for customers to independently manage the administration of episode of care plans.
“Bundled payments and episodes of care are part of the new reality of value-based reimbursements today,” said Steve Krupa, CEO of HealthEdge. “They will become even more important in the future and we are pleased to partner with the leader in the field, Remedy Partners, on this innovative offering.”
Remedy in the NewsRemedy Partners continues to be a strong advocate for the BPCI program and using bundled payment models as a path to healthcare transformation.
HealthEdge And Remedy Partners Launch Bundled Payments Initiative
Business Wire | June 21, 2017
Skilled Nursing ‘Under Siege,’ Quarter of Beds to Disappear by 2022
Skilled Nursing News | June 11, 2017
Put Bundles in the Toolkit: Highlights from The Seventh National Bundled Payment Summit
Bundled payments are the missing element from many organizations' toolkit for driving quality and efficiency. That was the theme emerging from the discussions taking place at the 2017 National Bundled Payment Summit which took place in Washington D.C. on June 26-28th.
Remedy Partners is proud to be a Bronze sponsor of AHIP - America's Health Insurance Plans Institute & Expo 2017 this year. The event takes place in Austin, Texas on June 7 – 9. AHIP is the premier conference for the health insurance industry.
Palliative care improves quality of life by relieving symptoms, providing psycho-social support, and by lowering costs by eliminating unwanted inventions, such as hospital readmissions.1,2 Because bundled payments approach episodes of care with the patient’s goals at the center of all care planning, bundled payments can help make palliative care available to patients by offering incentives that help avoid expensive care that may be at odds with the patient’s wishes. Further, effective January 2016, CMS reimburses physicians for “advanced care planning” activities that support palliative care as part of the updated Physician Fee Schedule under two new CPT codes.
Two recent studies demonstrate that the number of elective procedures does not vary significantly in bundled payment programs when compared to controls. Wilson, de Brantes and Conway analyzed1 the Medicare Bundled Payments for Care Improvement initiative to determine if the volume of Lower Joint Replacement (LJR) procedures increased under the model. Their analysis was in response to an editorial3 in the Journal of the American Medical Association that raised questions about elective procedure volume and bundled payments in an accompanying JAMA study.2
ACOs and episode payment models can and do work together. To be most successful, payers need to synchronize the payment models they sponsor for participating providers. To help the Medicare program in this task, the Health Care Transformation Task Force released principles to consider when apportioning responsibility between alternative payment models covering the same patients.
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.
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.
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.
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.