January 27, 2016
For nearly 50 years, Medicare has operated separate payment systems for hospitals, clinics, physicians, post-acute care facilities, and other categories of health care providers, with few incentives for coordinating care across the continuum of services. These systems support a fragmented delivery system at substantial cost to taxpayers and Medicare beneficiaries.
Policy analysts have long been interested in encouraging improved efficiency and care coordination by bundling Medicare payments for a range of services delivered during defined episodes of care. In 2011, the Center for Medicare and Medicaid Innovation of the Centers for Medicare and Medicaid Services (CMS) announced a Bundled Payments for Care Improvement (BPCI) Initiative and invited providers to apply for one of four new payment models to begin in 2013.
Across the nation, over 6,000 hospitals, physician group practices and post-acute care providers have applied to participate in the BPCI program. While not all of these providers will move forward into the risk-bearing phase of the program, the level of interest indicates that providers across the care continuum are reevaluating how care is delivered and working toward the “triple aim” – improving the experience of care, improving the health of populations served, and reducing per capita costs of health care.
Skilled nursing facilities (SNFs) are leading the charge, making up over half of all BPCI facility participants. That number jumps to 90% when looking at post-acute care providers only. Even more astounding is that this accounts for 22% of all SNFs nationwide. This participation rate far outpaces adoption of bundled payments by any other PAC setting.
Considering the magnitude of participation by skilled nursing facilities in bundled payment arrangements and available data, we have an opportunity to look retrospectively at what has worked well in bundled arrangements and what areas may require improvement. Using this information and “lessons learned” from participation, SNF providers can look to the future of health care delivery with a more positive outlook for success.
This training program will review the background and rationale behind bundled payments. Using available data, this session provides lessons learned from the initiative and strategies and tactics for participating in bundled payment initiatives.
Email form to: SShultz@LeadingAge.org
