White paper co-authored by Shawn Matheson of Remedy Partners and published by Leavitt Partners
CMS Embraces Innovation and Competition
Steve Wiggins with Nick Bluhm and Ryan PardoSeptember 20, 2017
Today, Seema Verma, the Centers for Medicare and Medicaid Services (CMS) Administrator, published a Request for Information seeking feedback on how to lead CMS’s Innovation Center in a new direction. Her statements reflect a belief in competition, consumer empowerment and a willingness to use waivers to enable meaningful innovation.
Remedy in the News
Remedy continues to be a strong advocate for the BPCI program and using bundled payment models as a path to healthcare transformation.>
CMS proposes changes to CJR: 6 key thoughts on what this means for orthopedic bundled payments
Becker's Spine Review | August 18, 2017
Is HHS’ Proposal to Scale Back Mandatory Bundled Payments a Step Back from Value-Based Care? Many Healthcare Experts Say No
Healthcare Informatics | August 18, 2017
Chris Garcia Named CEO of Remedy Partners
Remedy Partners, the nation’s leading bundled payment company, has named Chris Garcia its chief executive officer, effective July 12, 2017. Remedy is well-positioned for accelerated growth as the healthcare industry continues to adopt bundled payments as a core value-based payment strategy.
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.
Remedy recently convened 120+ clinicians and administrators representing over 90% of Remedy’s 437 Model 3 SNF partners from across the nation for the first-of-its-kind SNF Innovation Collaborative. This meeting highlighted the importance of collaboration on two fronts -- between Model 3 SNFs, and among all the providers in the post acute environment.
In January 2016, Remedy invited Model 3 SNF partners to create a local collaborative. The outcome was the launch of the Connecticut Post Acute Alliance (CPAA) – a network of Remedy Model 3 SNFs invested in improving the efficiency, coordination, and quality of healthcare services delivered throughout an episode of care. The Alliance represents over 90% of the Model 3 SNFs in Connecticut. It is almost three times larger than the largest SNF chain in Connecticut, so it is the best of both worlds - independently owned facilities dedicated to servicing Connecticut patients, and working together to leverage the benefits of being in the BPCI program with Remedy.
Gene Huang, Remedy Partners’ Vice President, Business Development, was a featured speaker at the 13th Annual HealthMEDX User Group in St Louis on April 12 - 14, 2016.
Bundled payment programs require effective care coordination encompassing the hospitalization and the post-discharge recovery period. Within this care coordination process, selecting the ‘next site of care’ after hospital discharge is a crucial element in the provision of high value patient care. Why? When looking at large data sets representing aggregate spending, the cost of post-acute care can rival that of the initial inpatient stay.(1) For many bundles, total 90-day episode spending for a patient discharged to a skilled nursing facility can be more than two times that of a patient discharged to home.(2)
Why CMS is Focusing on Post Acute Care
Healthcare is increasingly transitioning to value based payment models in an effort to control spending and improve quality. In 2014, the amount spent on healthcare in the U.S. per individual reached $9,523—more than twice the average of all other developed countries—and is projected to reach $14,103 by 2021 if unchecked. Total healthcare spending represents almost 18% of GDP, and is expected to grow to 20% in the next five years. Furthermore, Medicare alone represented 20% of National Healthcare Expenditures
in 2013, and is expected to increase significantly after 2015 due to growing utilization of medications and services by an aging population.
HIGHLIGHTS FROM REMEDY’S INNOVATION COLLABORATIVE
OCTOBER 1ST AND 2ND, 2015 | BALTIMORE, MD
Eric Hume, MD, orthopedic surgeon and Director of Quality and Safety for Orthopedics
at Penn Medicine, described acute and post acute care collaboration for joint replacement patients. He emphasized Collaborative Pathways – which specify interventions spanning
a recovery period – to assure a safe transition between acute and post acute care. Penn Medicine uses an Acute Transfer Tool to assure necessary information is included in the patient transfer such as: