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Find videos, learning materials, case studies and tools designed to assist you in navigating the often-
complex process of implementing bundled payment programs in your local healthcare settings.

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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.”

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Remedy in the News

Remedy 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

 

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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.

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Bundled Payments, Value Based Healthcare, Mandatory Bundles,, Medicare, EPM

Medicare Delays Mandatory Bundled Payments; Expansion of Voluntary Bundles Unaffected

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.

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Remedy Partners, Society of Hospitalist Medicine, Hospitalist, SHM 2016, Win Whitcomb, Value Based Care, Bundled Payments, SHM, Value Based Healthcare

Hospitalists Lead the Move to Physicians in Alternative Payment Models

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). 

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BPCI, SNF, Discharge Planning, Post-Acute, Bundled Payments, Value Based Healthcare

Selecting a High Value Next Site of Care: A Novel, Important Skill for the Inpatient Team

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)

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Care Redesign, BPCI, SNF, Value Based Care, SNF Performance Network, Preferred Provider, SNF Network, Bundled Payments, Value Based Healthcare, Episodes of Care

Narrow SNF Networks and Increased Collaboration: The Remedy Approach

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.

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Remedy Partners, Value Based Care, CJR, Bundled Payments, Value Based Healthcare, Comprehensive Care for Joint Replacement

The 6 Steps to CJR Success

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.

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Readmission, Value Based Healthcare, Care, Care Transitions

The Value of the Physician Visit During the First Week After Discharge

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.

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Glossary

Anchor Stay
The period of time between the admission date and the discharge date of an episode-initiating hospital stay for a patient.


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