CMS launches voluntary bundled payment program

Physicians, hospitals, and other providers who are interested in being financially incentivized to collaborate with one another now have four options for doing so under Medicare's new Bundled Payments for Care Improvement Initiative. The Affordable Care Act's new Center for Medicare and Medicaid Innovation launched the voluntary program, announced on Tuesday.

Previous experiments with bundled payments have shown them to be effective in cutting costs for a patient's entire episode of care, which could include, for example, all of the care a patient receives in and out of the hospital related to a heart attack.

While participating groups--which can include doctors' groups, hospitals, physician-hospital organizations, nursing homes, and others--may receive extra payment if they provide efficient care, there's no guarantee that any group would see significantly higher reimbursements under a bundled approach, Medpage Today reports.

According to CMS, the incentive that will drive hundreds of groups to apply for the program is that doctors and hospitals "want to work together to provide care" because the current system doesn't reward collaboration.

One of the key features of CMS's new program is its flexibility. Participants will be able to decide which episodes of care and which services will be bundled together by selecting one of the four payment models that each define the episode of care differently. Three of the options pay providers retrospectively, and one offers prospective payment. Under all of the models, which include a pre-negotiated discount on Medicare rates, the providers would be responsible for determining how one check is allocated among doctors, hospitals, and others.

"This Bundled Payment initiative responds to the overwhelming calls from the hospital and physician communities for a flexible approach to patient care improvement," said CMS Administrator Dr. Donald Berwick in a statement. "All around the country, many of the leading healthcare institutions have already implemented these kinds of projects and seen positive results."

To learn more:
- read the press release
- see the article from Medpage Today
- read this article from Internal Medicine News
- check out this post from NPR