From Edison, NJ to San Bernardino, CA, some hospitals and doctors will soon embrace big financial risks with four federal bundled payment models that allow them to reap some avoided Medicare costs, even though it may mean absorbing excess patients' expenses up to 90 days after they leave acute care settings.
"For doctors who have never managed care before, who stay independent, and have done a lot of fee for service medicine, this is a way to start changing the culture, which is what we need to do because the old dis-aggregated, specialty driven fee-for-service system is what's bankrupting this country," says Steven Barron, President of 463-bed St. Bernardine Medical Center in San Bernardino, CA.
William Oser, chief medical director of 498-bed JFK Medical Center in Edison, NJ, says that by working with doctors to be more efficient, and streamlining hospital services, for example adding certain test procedures on weekends, length of stay and therefore costs can be reduced.
"What we found is that if we are thoughtful, and actually in some cases provide more care but on a more timely basis, it's better for the patients and at the end, more efficient and less expensive."
Last week the Centers for Medicare & Medicaid Services officially rolled out these four models of bundled payments prescribed by the 2010 healthcare reform law. They are intended to drive efficiency in the care of expensive Medicare patients. The models' designs vary in how they bundle episodes of care, and may even vary with each hospital's negotiated contract.