Bundled Payment Pilot

Policy Implications in Managing Risk under Bundled Payment

Under episode-based bundled payment systems, a provider contacting organization is paid a fixed amount for all care required by patients who meet the definition of the episode.  Since no definition of episodes results in a totally homogeneous group of patients, cost of individual patients vary, and therefore the contacting organization is subject to random variations in its average per-patient cost depending on which patients are included in its episodes. As bundled payment models evolve, two different methods of managing these types of variations appear to have emerged.

BPCI May Be the Best Bundled Payment Deal You'll See for a Long Time

OK, it’s a little late to be saying this, but there may be some providers who are on the fence about participating in the Medicare bundled payment initiative and need a little push.  Many providers have looked at the data and decided that bundled payments aren’t right for them at the moment.  Others may be still considering the alternatives.  Here’s one more factor to consider – the Bundled Payment for Care Improvement initiative may be the best deal you’ll see for a long time – perhaps ever.

Hedging Readmission Risk in Bundled Payment

Readmission DRGs fall into two groups.  The first group is the DRGs for readmissions that occur several times throughout the year, and appear consistently across years.  These readmission DRGs appear to be good candidates for clinical interventions.  The second group is the “singleton” DRGs that occur only once during a year for a specified index DRG.  These DRGs have little consistency across years, appear to have minimal potential for clinical intervention, and behave somewhat randomly.

Early Physician Involvement is Critical in Bundled Payment Analysis

The analysis and preparation process for the Bundled Payment for Care Improvement initiative is now entering its final month.

Singletrack News - June 2012

Singletrack Principal Jon Pearce will be presenting on "Data Analytics for Healthcare Financial Managers" at the PICPA Healthcare Conference on June 11, 2012.  This session will discuss the challenges financial managers face to acquire information in databases, such as those provided by CMS to ACOs and bundled payment participants.

Selecting Episode Length in Bundled Payment

In the Bundled Payments for Care Improvement (BPCI) initiative, an important decision involves selecting the length of the episode.  According to the CMS application guidelines, organizations choosing a minimum 30 day episode must propose a discount equal to at least 3% of the historical cost of the episode, while organizations selecting a minimum 90 day episode may propose a minimum 2% discount. 

Analyzing Bundled Payment Data with PowerPivot

Attendees at this year’s Phila HFMA Decision Support and Financial Technology seminar heard several sessions describe the new PowerPivot add-in for Microsoft Excel.  Presenters described its ability to handle large million-row data sets with extremely fast response times.  But  how big can the datasets be, and how fast is the response time? 

CMS Extends Bundled Payment Application Deadline to June 28

You'd have to be blind not to see that coming, right???

Info is on the CMMI bundled payment website

CMS Changes Bundled Payment Calculation

Many participants on today’s Technical Assistance Conference Call were surprised to hear the change to the payment calculation that will now be required for the bundled pricing proposal.

Risk Adjustments and Bundled Payments

The CMS guidelines for the Medicare bundled payment initiative suggest that CMS will be receptive to the use of risk adjustments in establishing the episode payment budget for DRGs to be paid under this program.  This prompted the Singletrack Analytics research team to fire up its HCC grouper to explore how risk adjustment might be integrated into a bundled payment process.

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