The Centers for Medicare and Medicaid Innovation (Innovation Center) now is accepting applications for 4 models of care under its Bundled Payments for Care Improvement initiative. Hospitals, physician group practices, inpatient rehabilitation facilities, skilled nursing facilities, home health agencies, and other health care providers, can apply to participate in this new program that will align payments for services delivered across an episode of care, such as a hip replacement, rather than paying for services separately. According to the Innovation Center, bundling payment across providers for multiple services will offer a greater incentive to coordinate and ensure continuity of care across settings, resulting in better care for patients.
Three models involve a retrospective bundled payment arrangement, 1 model would pay providers prospectively. Through the initiative, providers have flexibility in selecting conditions to bundle, developing the health care delivery structure, and determining how payments will be allocated among participating providers. Applicants for these models also would decide whether to define the episode of care as the acute care hospital stay only (Model 1), the acute care hospital stay plus post-acute care associated with the stay (Model 2), or just the post-acute care, beginning with the initiation of post-acute care services after discharge from an acute inpatient stay (Model 3). Under the fourth model, CMS would make a single, prospective bundled payment that would encompass all services furnished during an inpatient stay by the hospital, physicians, and other practitioners.
Organizations interested in applying to the Bundled Payments for Care Improvement initiative must submit a letter of intent by September 22 for Model 1 and November 4 for Models 2, 3, and 4. Final applications must be received by October 21 for Model 1 and March 15, 2012, for Models 2, 3, and 4. Providers participating in Accountable Care Organizations are encouraged to submit applications. Click here for more information about the initiative and various models.