CMS Trials Bundled Payments for Episodes of Care

Cheryl Clark, for HealthLeaders Media , August 24, 2011

"Physicians and hospitals have not always had the most equal relationship," said Nancy Nielson, MD, Innovation Center Senior Adviser. "This gives them the opportunity to come together as true partners for the benefit of the patient."

Nielsen added, "Think about the number of things that happen: in the emergency room, radiology, anesthesiology, surgery, medications. It's very complicated and the point here is (to say there will be) no more barriers between the people who need to redesign that care."

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During the news briefing, Valinda Rutledge, Director of the Innovation Center's Patient Care Models Group, emphasized that in order to approve hospitals under Model 1, "we want to know what physicians and other providers are part of this, and we want to see letters of support. So if we get an application that doesn't look like it's very robust, in terms of the number of physicians that are participating in it, and they have a medical staff of 500 or 600, and we see only five letters of support, that will raise a lot of questions for us."

"The beauty of innovation is unleashing the creativity and energy of people, who now know if they are focused on delivering the best outcomes of patients, they don't have to be worried about whether they're going to get paid for this service or not paid for that service. And therefore, people will come up with the best way to deliver care that may involve services that we can't even conceive of today.

Initial reaction to the Obama Administration's bundled payment proposal was positive.

"The current system hospitals paid one way, doctors paid another way, and post acute care paid another way," said Blair Childs, senior vice president of Public Affairs for Premier Healthcare Alliance, a quality improvement and purchasing organization with 2,400 provider members. "What this does, it links them all."

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