CMS: Success of bundled-payment program leads to 360 new participants

After a Centers for Medicare & Medicaid Services bundled payment pilot project saved $1 million its first year while strengthening outcomes, the agency announced 360 more providers will join the program.

Instead of Medicare making separate payments to providers for each individual service they provide to patients for a single illness or course of treatment, under the bundled payment initiative the agency pays a lump sum for an episode of care. The goal of the program is to improve care coordination across providers and healthcare settings. 

In addition to the new participants, another 1,755 providers will partner with them and assume the same financial risk for episodes of care.

"By focusing on outcomes for an episode of care, rather than separate procedures in care delivery, we are incentivizing hospitals, doctors and other providers to work together to provide high quality, coordinated care for patients," Patrick Conway, M.D., CMS acting principal deputy administrator and chief medical officer, said in a statement. 

Participants will operate under four different payment models, with the models varying based on provider type and length of the bundle after admission. Although CMS is hopeful that the bundled payment program will result in significant savings and better patient care, a March report found little difference in care quality after providers implemented a bundled payment model, and in some cases readmission rates and emergency room use were actually higher for bundled payment participants.

To learn more:
- here's the CMS announcement
- check out the payment models

Related Articles
Bundled payment project saved $1M in first year
Verdict still out on Medicare bundled payments 
Design influences bundled payment success  
We need more bundled payments--fast  
Many providers still on fence regarding bundled payments