Bundled Payments for Medical Home Reimbursement

A participant in CMS's Acute Care Episode demo piloting the use of bundled or episodic payments will share early feedback from the experience during the September 16, 2009 webinar, "Medical Home Reimbursement: Exploring Bundled Payment Options," part of the summer-long HIN Medical Home Open House Series.

July 23, 2009

MANASQUAN, NJ, USA — Bundled or episode-based payments — a single payment for all services related to a treatment or condition, possibly spanning multiple providers in multiple settings — are gaining momentum as the healthcare industry explores alternatives to traditional fee-for-service payment methods. Baptist Health System of San Antonio, one of three participants in CMS's Acute Care Episode (ACE) demo pilot testing the use of bundled payments for a select set of cardiac and orthopedic inpatient episodes of care, will share its experience during "Medical Home Reimbursement: Exploring Bundled Payment Options," a 45-minute webinar on September 16, 2009 at 1:30 Eastern.

This new session continues the summer-long Medical Home Open House series, which presents key topics in PCMH implementation — from staffing models, care transition management, behavioral health integration, reimbursement and contracting negotiations, accountable care organizations, patient education and engagement and much more. Visitors can customize their tour to their organization's needs, choosing one or more sessions in the series.

Learn more about bundled or episodic payment options for medical home reimbursement.

NEWS FACTS:

Scheduled Speaker: Michael Zucker, chief development officer, Baptist Health System.
Conference Focus: Baptist Health System, one of three CMS-identified value-based care centers in the pilot, will share experience and early feedback from the demo. CMS's ACE demo is testing the use of bundled payments — also referred to as "case rates" — for a select set of inpatient episodes of care to improve the quality of care delivered through Medicare fee-for-service. You'll hear details on how they've structured the payment, adjusting for severity, coordination and negotiation of the services and preparing for transitioning to real-life application.
Other sessions in the Medical Home Open House series: Meet the Medical Home Neighbor: Accountable Care Organizations on 7/29/09 at 1:30 Eastern; Patient Engagement and Education in the Medical Home: Perspectives from Several Pilots on 8/5/09 at 1:30 Eastern; Constructing Care Transitions to Reduce Hospital Admissions on 8/26/09 at 1:30 Eastern; Successful Staffing Models for Medical Home ROI on 9/9/09 at 1:30 Eastern; Under One Roof: Integrating Primary Care and Behavioral Healthcare in the Medical Home, 7/1/09, archive version; Medical Home Contracting: Building a Solid Framework, 7/8/09, archive version.
Webinar Formats: 45-minute live webinar on September 16, 2009, including Q&A; “On-Demand” rebroadcast available September 18, 2009; 45-minute training DVD or CD-ROM with printed transcript available October 7, 2009. Discounts available for two or more sessions in the Medical Home Open House series. Participants may add a DVD or CD to their live session registration to share with colleagues. Learn more about bundled or episodic payment options for medical home reimbursement.

QUOTE ATTRIBUTABLE TO MELANIE MATTHEWS, HIN EXECUTIVE VP AND COO:

Click here for Melanie Matthews's profile.

"The implications of the CMS bundled payments pilot are not only a reduction in healthcare costs for the selected inpatient procedures, but also an opportunity for participating hospitals to improve care delivery and coordination among specialists and benefit from “gainsharing” — provider incentive programs that allow physicians and hospitals to share remuneration for achieving improvements in efficiency and quality."

Please contact Patricia Donovan to arrange an interview or to obtain additional quotes.

About the Healthcare Intelligence Network — HIN is the premier advisory service for executives seeking high-quality strategic information on the business of healthcare. For more information, contact the Healthcare Intelligence Network, PO Box 1442, Wall Township, NJ 07719-1442, (888) 446-3530, fax (732) 292-3073, e-mail info@hin.com, or visit http://www.hin.com.

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