AHA says there are opportunities in bundled payments

A new report by the American Hospital Association (AHA) says that there is a huge opportunity for acute care providers to engage in bundled payment initiatives.

"Hospitals have many opportunities to improve quality and achieve positive financial results in bundling programs," the AHA report read. "In contrast to ACO initiatives that generally focus on primary care, bundled payment offers an opportunity to directly engage specialist physicians in care redesign."

Bundled payments are now being pushed by the federal government. The Centers for Medicare & Medicaid Services announced a bundled payment program for joint replacements that is expected to save the Medicare program $343 million over five years. However, there are no controls that would prevent hospitals from performing more joint replacements than what might be absolutely necessary--a potential concern for all bundled payment programs.

And other data show that providers are reluctant to participate in bundled payment initiatives as their financial risk grows.

Meanwhile, a hospital's success in a bundled payment program is predicated on a number of factors.

Hospitals "need systems for identifying patients likely to qualify for bundled episodes early--particularly if they are at high risk for complications or are likely to need medical or social support after they are discharged," according to the AHA. "Second, hospitals will need to establish teams that will work with physicians to implement standard care processes to reduce treatment variation. Such efforts have been shown to reduce complications, readmissions and hospital  length of stay when they are implemented effectively. Hospitals also need to have a high-functioning discharge planning process."

There will also have to be contingencies to deal with issues such as variations in spending caused by pricey outlier cases, the report said.

To learn more:
- read the AHA report (.pdf)

 
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