CMS NEWS
FOR IMMEDIATE RELEASE
August 13,
2015
Contact: CMS Media Relations
(202) 690-6145 | CMS
Media Inquiries
CMS
announces additional participants in pilot project to improve care and reduce
costs for Medicare
Over
2,100 participants in performance period of Bundled Payments for Care
Improvement initiative
The Centers for Medicare & Medicaid
Service (CMS) today announced that over 2,100 acute care hospitals, skilled
nursing facilities, physician group practices, long-term care hospitals,
inpatient rehabilitation facilities, and home health agencies transitioned from
a preparatory period to a risk-bearing implementation period in which they
assumed financial risk for episodes of care. The participants include 360
organizations that have entered into agreements with CMS to participate in the
Bundled Payments for Care Improvement initiative and an additional 1,755
providers who have partnered with those organizations. CMS defines an episode
of care as the set of services provided to treat a clinical condition or
procedure, such as a heart bypass surgery or a hip replacement.
“We are excited that thousands of
providers in the Bundled Payments for Care Improvement initiative have joined
us in changing the health care system to pay for quality over quantity -
spending our dollars more wisely and improving care for Medicare beneficiaries,”
said Patrick Conway, M.D., CMS acting principal deputy administrator and chief
medical officer. “By focusing on outcomes for an episode of care, rather than
separate procedures in care delivery, we are incentivizing hospitals, doctors
and other providers to work together to provide high quality, coordinated care
for patients.”
Bundling payment for services that
patients receive across a single episode of care is one way to encourage
doctors, hospitals and other health care providers to work together to better
coordinate care for patients, both when they are in the hospital and after they
are discharged. Through the Bundled Payments for Care Improvement initiative,
CMS is testing how bundled payments for clinical episodes can result in better
care, smarter spending, and healthier people. Today’s announcement means
several hundred providers are advancing into a program that rewards them for
increasing quality and reducing costs while also penalizing them if costs
exceed a set amount.
The initiative includes four models
of bundled payments tied to inpatient hospital admission. The models vary by
the types of providers involved and the length of the bundle after the
hospitalization.
CMS recently announced a new
Medicare Part A and B payment model, the Comprehensive
Care for Joint Replacement Model. Although the Comprehensive Care
for Joint Replacement Model is distinct from the Bundled Payments for Care
Improvement initiative, both initiatives are part of the innovative framework
established by the Affordable Care Act to move our health care system toward
one that rewards providers based on the quality, not quantity, of care they
deliver to patients. The Administration earlier this year announced the goal of
tying 30 percent of Medicare payments to quality and value through alternative
payment models by 2016 and 50 percent of payments by 2018.
To learn more about the Bundled
Payments for Care Improvement initiative and to see the list of participants
for Models 1, 2, 3 and 4, visit: http://innovation.cms.gov/initiatives/bundled-payments.
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