As the health care industry waits for a decision from the Centers for Medicare and Medicaid Services (CMS) about a potential delay in the ICD-10 compliance date, a new survey indicates that many providers still have much preparation to do before adopting ICD-10.
The readiness survey, conducted by the Workgroup for Electronic Data Interchange (WEDI), was submitted to CMS as another resource during the ongoing deliberations about a possible ICD-10 delay.
Survey finds many providers mired in ICD-10 'unknowns'
Health systems around the country are considering bundled payment for a variety of strategic reasons—improving alignment with specialists, reducing implant and device costs, and driving quality improvements through clinical standardization. Early adopters have been successful on all three fronts, as the Council has detailed in its Finance Road Map for Bundled Payment.
The evidence for market share shifts as an ancillary benefit of bundled payment is mixed, but a few providers—including the Cleveland Clinic, which two weeks ago announced a new direct-to-employer bundle with Boeing—have set their sights squarely on volume growth.
Expanding patient volumes with bundled payment
Bundled payment has received growing attention in the last few years, especially in the wake of health reform. With applications for the Medicare Innovation Center’s Bundled Payments for Care Improvement (BPCI) initiative due on May 16, 2012, many health systems are now turning from a strategic perspective (why should we consider bundled payment?) to more tactical concerns.
As part of the application process, health systems interested in BPCI must select the subset of Medicare DRGs to cover through bundled payment. This is a critical step, since the potential for savings may vary drastically from one DRG to another.
We have recently published a new white paper that includes a number of criteria we believe should guide the selection of DRGs to be bundled:
- High implant and device costs
- Long length of stay (or high variability in length of stay)
- Significant potential for spillover benefits (i.e., lower costs and higher quality realized for commercial as well as Medicare patients)
- Physicians with high strategic value
Clinical targets for bundled payment—what you should consider