CMS Unveils 4 Bundled Payment Models

Cheryl Clark, for HealthLeaders Media , February 4, 2013

CMS said in a news release Thursday that 500 hospitals will participate at one level or another, although only 32, including St. Bernardine, 343-bed Community Hospital San Bernardino, and JFK, are opting for Model 1 when the program kicks off in April.

The Association of American Medical Colleges has 10 hospitals—from University of California San Francisco Medical Center to Albert Einstein Healthcare Network in Philadelphia—participating in Models 2 and 4.

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This effort necessitates hospitals and doctors "looking in depth at the current processes of care in the preadmission period, in  admission period, in post-acute period in the primary care period and really evaluating, where's the waste, where's the inefficiency, where are the quality problems right now?" says  Coleen Kivlahan, MD, the AAMC's Senior director of Health Care Affairs. "And where are we doing things that we don't really, have evidence base attached to those, and eliminate those."

The bundling models also requires that hospitals meet quality metrics and mortality statistics, to make sure that patients are better off, or at least no worse off than they were through the traditional payment model.

JFK's Oser says CMS' official bundled payment announcement extends a project his hospital has been doing for several years, and they've already realized what efforts seem to work.

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2 comments on "CMS Unveils 4 Bundled Payment Models"

Peter Reisman (3/21/2013 at 7:40 PM)
It sounds simple, but these models will require substantial IT, medical records, accounting and management coordination support on the provider side, and claims processing, medical review, policy review and fraud control oversight on the government side. I have my doubts about the government's ability to manage them adequately.

Beryel Cox (2/5/2013 at 9:23 AM)
What needs to be done is the hiring of Health Information Management major at the partner level. Move beyond the old paradigm that the HIM graduate is well trained in Medical Record. The modern HIM Associate and Bachelor degree programs around this country and Canada are teaching us Health care systems. There is becoming a large pool of well trained HIM graduates that need the opportunity to do their PPE and find that first foot in the door. What other training program has as many classes in CMS payment models than the AHIMA approved programs. We are trained in understanding health care economics from the very first class, until we graduate. We understand the complex systems of modern health care. The HIM graduates are the rescue preservers for the sinking healthcare revenue ship. Understand what we study, understand how grueling the course of study is for a HIM major and then contact your local Community College and four-year college an hire from a AHIMA approved program. We all need employment!




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