CMS Releases Information About Bundled Payments

The Centers for Medicare and Medicaid Services recently issued more information about the Bundled Payment for Care Improvement initiative, including a preliminary list of 48 episodes of care that would pay a targeted rate that is less than actual fee for service payments. If applied to all providers, these episodes would cover around 70 percent of all Medicare expenditures. Three bundled payment models will be tested as part of the initiative: payment for an inpatient stay for one of the 48 inpatient conditions plus targeted payments for services provided 30 or 90 days post-discharge, payment for post-discharge services associated with one of the 48 inpatient conditions, and payment for inpatient stays only. Hospitals will have to make several changes to meet the discounted targets in these bundles, including contracting, forging joint ventures, or vertically integrating with post-acute care provider practices to manage and coordinate post-discharge services.


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