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  • CMS Bundled Payment Initiative to Begin Testing in April

    More than 500 organizations will begin participating in the Centers for Medicare and Medicaid Services' (CMS) bundled payments for care improvement initiative, made possible by the Affordable Care Act. Through this initiative CMS will test how bundling payments for episodes of care can result in more coordinated care for beneficiaries and lower costs for Medicare.

    The bundled payment initiative includes 4 models of bundling payments, varying by the types of health care providers involved and the services included in the bundle. Depending on the model type, CMS will bundle payments for services that beneficiaries receive during an episode of care, encouraging hospitals, physicians, postacute facilities, and other providers as applicable to work together to improve health outcomes and lower costs. Organizations of providers participating in the initiative will agree to provide CMS a discount from expected payments for the episode of care, and then the provider partners will work together to reduce readmissions, duplicative care, and complications to lower costs through improvement.

    Last week's announcement includes the selection of 32 awardees in model 1, who will begin testing bundled payments for acute care hospital stays as early as April. In the coming weeks, CMS also will announce a second opportunity for providers to participate in model 1, with an anticipated start date of early 2014.  

    CMS' announcement also marks the start of phase 1 of models 2, 3, and 4. In phase 1 (January-July 2013), more than 100 participants partnering with over 400 provider organizations will receive new data from CMS on care patterns and engage in shared learning in how to improve care. Phase 1 participants are generally expected to become participants in phase 2, in which approved participants opt to take on financial risk for episodes of care starting in July 2013, pending contract finalization and completion of CMS' standard program integrity reviews. 

    A list of the model 1 awardees and participants for phase 1 of models 2, 3, and 4 is available on the Center for Medicare and Medicaid Innovation's website.

    Hear how physical therapists are getting involved in bundled payment initiatives by attending APTA's Innovation Summit: Collaborative Care Models. This groundbreaking virtual event will bring together physical therapists, physicians, large health systems, and policy makers to discuss the current and future role of physical therapy in integrated models of care. A panel of experts, moderated by a physical therapist who is highly involved in bundling initiatives, will provide you with perspectives on bundling from large health systems, a physical therapy private practice, and private payers.

    Registration for the Summit closes Friday, February 8. Interested in attending a viewing party in your area? APTA will soon list viewing parties and their locations at www.apta.org/InnovationSummit/ViewingParties/.  


    • What is the incentive for the first provider to "pass on" the savings from the efficeint care they provide? Dollar amounts per Dx only promotes limited care for the patient. How many providers will treat beyond the "bundled/discounted" rate CMS will pay? How much longer can we accept pay cuts every year?

      Posted by Brett Michener on 2/4/2013 1:53 PM

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