More than 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 model, CMS reported last week. The group includes 360 organizations participating in the Bundled Payments for Care Improvement (BPCI) initiative and an additional 1,755 providers who have agreements with those organizations.
“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.”
CMS said that now several hundred providers will be rewarded for increasing quality and reducing costs, while also penalizing them if costs exceed a set amount.
Through BPCI, CMS pays a lump sum to a convening organization for a set of services provided to treat a clinical condition or procedure, such as a heart bypass surgery or a hip replacement.