CMS Unveils 4 Bundled Payment Models

Cheryl Clark, for HealthLeaders Media , February 4, 2013

For example, he says, in addition to adding weekend services to speed care and reduce lengths of stay, JFK added a second CT scanner to speed imaging. It also created multidisciplinary rounds, including respiratory therapists and pharmacists for every patient.

And JFK is streamlining and narrowing the variation by which doctors treat heart failure patients, and for patients who present in the emergency department with heart issues, there are protocols that call for a cardiologist to be present within the first 12 hours.

"If we work harder during the discharge to make sure the patient is educated, and understands medications, there's a higher likelihood of compliance," Oser says.  

"We can probably safely treat and care for the patient and discharge them in [fewer] days than we formerly did because of a less disciplined or less consistent practice, and we can minimize the likelihood  that they're going to be readmitted to the hospital in the next 30-60 days."

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St. Bernardine's Barron says that at his hospitals, the project includes nurse practitioners making daily phone calls to certain Medicare beneficiaries with chronic disease up to 30 days, and make sure medications are appropriate and that they're able to see an appropriate physician quickly.

"Sometimes the medications the hospitalist gives are not the same as what's on their formulary with their insurance plan, or what their primary care physician or cardiologist wants them to have," Barron says. "Sometimes they don't get in to see their doctor immediately after discharge, and things can get mixed up."



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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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