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.
Remedy Partners’ 2017 National Innovation Collaborative:
The Year’s Largest Gathering of Professionals Dedicated to Bundled Payments
Remedy Partners November 13, 2017
This year’s largest gathering of bundled payment operators will convene at Remedy Partners’ Fourth Annual National Innovation Collaborative in Atlanta, GA on November 16 -17. The conference, open to Remedy Partners’ clients and collaborators, is expected to garner more than 350 attendees. It will balance presentations from industry thought leaders with those of professionals working in bundled payment programs on a daily basis.
Remedy in the News
Bundled Payment Report Illustrates Increased Demand for Home Health
Home Health Care News | November 2, 2017
Remedy Partners names EVP of commercial business lines: 3 things to know
Becker's Hospital Review | November 1, 2017
Three reasons your SNF should sign up for CMS's BPCI Advanced Program
McKnight's Long-Term Care News | November 1, 2017
Remedy Partners Announces that One Hundred Percent of its Hospital Partners Achieve Positive Net Payment Reconciliation Amount (NPRA) in Bundled Payment Initiative
Medicare’s voluntary BPCI program’s financial results reveal positive NPRA for 100 percent of Remedy Partners’ engaged hospitals and 81 percent of its partner clients
The Society of Hospital Medicine recognizes 2016 as the Year of the Hospitalist, commemorating 20 years since the term hospitalist was coined and the Society of Hospital Medicine was formed. Bob Wachter and Lee Goldman sparked the latent hospitalist movement with an article titled ‘The emerging role of ‘hospitalists’ in the American Healthcare System’ in an August 1996 issue of The New England Journal of Medicine. Several weeks later, John Nelson and I, both practicing hospitalists, formed the Society of Hospital Medicine (then incorporated in 1997).
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.
To be successful in this program, you will need to optimize your day-to-day workflow, ensuring that your patients receive better care at a lower cost. We at Remedy Partners believe that there are 6 Steps to Success.
My pager interrupts a conversation with a patient’s caregiver. It’s an outside pharmacy, the message reads, “Mr. Smith needs a refill on his diuretic, please call xxx.” I pause, Mr. Smith, who was he? I recall he was discharged 4 weeks ago! He was pretty ill when he presented to the hospital with heart failure, but he pulled through after a few tough days. We managed to discharge him home with prescriptions for a month and asked that he follow up with his PCP within 7 days. So, what happened? Did he not see his doctor? I hope he’s not getting worse and about to be readmitted. I promptly investigated and discovered that the earliest appointment with his PCP was 6 weeks after discharge.