In this episode, Maria Miranda, Director of Reimbursement Services at BESLER Consulting discusses her impressions and findings from a recent meeting focused on bundled payments. She examines clinical vs. financial approaches to the issue and predictions for mandatory Medicare bundled payment programs going forward.
Maria noted that one of the things that stuck out most at this meeting was the need to view bundled payments as a clinical venture and not just a financial one. Maria believes you’ll be more likely to succeed with bundled payments if you focus on improving patient satisfaction and improving outcomes.
One of the biggest concerns that Maria found among attendees was the difficulty in working with CMS data related to bundled payments.
For some hospitals, being a part of a mandatory bundled payment program like Comprehensive Care for Joint Replacement (CJR) may be new because now they are accepting risk regardless of whether or not they participated in bundled payment programs before.
Larger hospitals who have the resources to manage CMS data and those with their own health plans may have an easier time dealing with CJR in the short term. In a program like CJR, hospitals have access to their own data, but not necessarily payment data for post-acute facilities which can make decision making difficult.
Maria noted several clinical approaches that could impact how hospitals manage their risk under bundled payments include telemedicine, pre-admission preparation, apps, and patient navigators. On the financial side, hospitals will be working to identify a short list of key collaborators they can work with to enhance care and share risk under CJR.