Despite recent political shifts, bundled payment programs are likely here to stay as a practical step toward value-based care. Currently CMS is planning to implement an expansion July 1st of the mandatory CJR bundled payment model that launched in January. This will soon include additional joint surgery types under the CJR model and the new cardiac bundles. (Update: CMS delays the bundled payments expansion)
Healthcare organizations are already making progress in preparation. Bundled payment models start with clinical care redesign—something most healthcare organizations are already skilled at doing.
Improving care processes on the way to value-based care
Many providers are revamping care processes, improving collaboration among clinicians and using data to zero in on at-risk patients to better serve their patients. These steps lead to improved clinical outcomes, as well as optimized reimbursements.
These steps are also some of the key areas that providers can focus on to participate successfully in voluntary or mandated bundled payment arrangements. Doing this proactively helps IDNs confidently manage clinical and financial risk, strengthen population health initiatives, and optimize return on bundled payment models.
Bundled payment success enhances population health
Success under bundled payment arrangements starts with targeting meaningful opportunities for cost reduction and patient-centered care management—both key tenets of population health. Doing this can help IDNs:
- Strategically align around specific bundled payment opportunities
- Evaluate levels of risk in patient populations to identify the highest-risk, highest-cost patients
- Drive toward prevention and intervention programs based on bundled arrangement requirements
- Prevent avoidable hospital admissions and readmissions
- Leverage clinical and financial insights to inform future risk contracting and compliance efforts
As your organization gains experience, it will be better prepared to succeed at additional population health and bundled payment programs down the road, improving patient care and optimizing value-based reimbursements.
Choose a partner now that can set your organization up for success. To learn more about how to achieve improved outcomes & lower cost through bundled payment arrangements,Watch a recorded version of my Achieving Triple Aim Success in Bundled Payment Models Webinar.