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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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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?
We're only two months into 2013, and this has already proven to be a busy year for payment innovation. So far, we have welcomed 106 new Medicare ACOs and more than 450 Medicare bundling sites—not to mention the range of program and pilots underway in the private sector.
This year also marks an important evolution in the transition to accountable care. Providers are increasingly shifting focus from evaluating potential payment models to operating under new risk-based contracts.
To support providers beginning to tackle risk-based contracts, I want to introduce Toward Accountable Payment readers to our sister blog, the Care Transformation Center Blog. Log in now to subscribe to their email alerts.
Meet the Care Transformation Center Blog