Premier participants are focusing on Model 2 of the CMS pilot project, which covers the episode of care defined as including hospital, physician, post-acute provider, and other Medicare-covered services provided during the inpatient hospital stay as well as following discharge. The promise of the program, as in all the bundled payment programs, is to share gains arising from better coordination of care.
Premier's Wes Champion says the program "is based on a decade's worth of experiences and lessons learned through our collaborative that have shown substantial cost and quality improvements."
Some of the Premier participants have already joined CMS's demonstration project, but you don't have to do so to learn how best to structure your approach to bundled payments.
A second opportunity to learn how to approach bundled payments, launched at the beginning of this year, comes from VHA, another national healthcare network, through its Bundled Payment Simulation project. Similarly, that initiative helps simulate volume and reimbursement projections for total knee replacement episodes of care, thus helping senior leaders on both the clinical and financial sides to assess risks and analyze the return of the potential investment in changing care patterns.