During the inaugural call of our Bundled Payment Finance Initiative last week, we heard from finance executives at 20 institutions around the country that are pursuing or planning to pursue bundled payment contracts. Part of the discussion centered on how to select clinical conditions to bundle—a requirement for systems planning to participate in the Medicare Innovation Center’s Bundled Payments for Care Improvement (BPCI) initiative.
One finance executive whose system currently bundles select cardiac and orthopedic surgeries cautioned against bundling payments for orthopedic revisions (procedures to fix or replace an existing hip or knee implant). These revisions (DRGs 466-468) are included in his current bundled payment contract but for several reasons are troublesome targets for bundling.
Be cautious about bundled pricing for orthopedic revisions