About This Blog
Welcome to Toward Accountable Payment, the official blog of the Medicare Payment Innovation Project. The project is an ongoing initiative to study provider payment reform and support organizations engaging in innovative payment programs.
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We've already received over 110 responses from senior health care executives to our 2013 Accountable Payment Survey—an ongoing benchmarking initiative to demonstrate where our industry stands in the move toward payment reform, and where its leaders expect to go in the coming years.
While the group appears similar in size and composition to the 2011 participant pool, initial data suggests that attitudes toward risk have changed significantly.
Survey results: Percentage of providers taking on risk doubled since 2011
Yesterday, the Center for Medicare and Medicaid Innovation (CMMI) announced two significant changes to its largest accountable payment program, the Bundled Payments for Care Improvement (BPCI) initiative. There are currently more than 450 providers slated to participate in the program, which reimburses entire episodes of care—in some cases including all related physician services, readmissions, and post-acute care—at a single rate.
BPCI update: Three-month delay, fewer metrics to report
Rob Lazerow and Jordan Stone
In our initial analysis of the clinical conditions selected by BPCI participants, we were surprised to find that nearly half of selected conditions were medical rather than surgical. This was a clear departure from earlier Medicare and private sector bundling programs, which focused almost exclusively on surgical care.
Although BPCI includes a near even split of medical versus surgical care as a whole, this trend is heavily influenced by the 165 post-acute care providers participating in Model 3. In fact, we find very different participation trends when we narrow our focus to acute care providers, the organizations selected to participate in Models 2 and 4.
Are Medicare bundling programs embracing—or avoiding—medical conditions?