The early bird gets the bundled payment program worm

Tamara Cull
Vice President, Market Development

How can providers turn bundled payment program requirements into growth opportunities within value-based care? Get in early.

The largest financial returns are realized in the first years of a bundled payment program, like CMS’ Bundled Payments for Care Improvement (BCPI). With an upcoming window to apply for the next BCPI program by April 30th, now is a great time to get the ball rolling.

Timing as a competitive edge

Bundles include an element of measuring each provider against themselves and their peers on key care coordination benchmarks such as readmission rates and post-acute care utilization. For those organizations that are already successfully managing clinical and financial risk as part of a population health strategy, this opens the door to opportunities for higher savings from day one.

In the early years of a bundled program, those that meet and exceed the benchmarks can maximize the amount of time their organization is eligible for set funds shared among a growing number of providers each year.

So how do you get your organization to buy in? Recognizing that bundled payment models are ultimately a care redesign opportunity often motivates clinicians to jump at the chance to offer end-to-end care in a way they have always wished they could.

Population health management for early savings success

Providers can capture these early savings if they work now to develop comprehensive population health management programs for high-cost, complex patient populations and prepare for a growing set of bundles from government and commercial payers. To get started organizations need to:

  • Gain internal alignment on bundled payment goals and related care design
  • Implement a data aggregation system that can reveal gaps in care to drive toward prevention and intervention programs
  • Target clinical episode populations with the highest opportunities for improved care outcomes and the most savings
  • Review population care data and leverage insights to make improvements in clinical and financial outcomes

With the proper tools, technology and people in place, providers can successfully participate in voluntary or mandatory bundles based on the level of risk they’re willing to take on at a given time. There is a proven formula for success, so make sure your organization is on the upside of bundled payment risk.

The bottom line: Population health management and bundled payment management go hand in hand. Zero in on clinical and financial risk through population-specific bundles to turn mandates into opportunity.

Watch a recorded version of my Achieving Triple Aim Success in Bundled Payment Models Webinar.

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