Medicare's voluntary bundled payment program grows by 2,100 participants

CMS announced Thursday that 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 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 that have partnered with those organizations.

The BPCI initiative is composed of four broadly defined care models, which bundle payments for multiple services beneficiaries receive during an episode of care. Under the initiative, organizations enter into payment arrangements that include financial and performance accountability for an entire episode.

"We are excited that thousands of providers in the Bundled Payments for Care Improvement initiative have joined us in changing the healthcare system to pay for quality over quantity — spending our dollars more wisely and improving care for Medicare beneficiaries," said Patrick Conway, MD, acting principal deputy administrator and CMO at CMS. "By focusing on outcomes for an episode of care, rather than separate procedures in care delivery, we are incentivizing hospitals, physicians and other providers to work together to provide high quality, coordinated care for patients."

The announcement follows CMS' proposal last month requiring hospitals to be held accountable for the quality of care they deliver to Medicare beneficiaries for hip and knee replacement from surgery through recovery. Through the proposed five-year Comprehensive Care for Joint Replacement payment model, hospitals would continue to be paid under existing Medicare payment systems. However, the hospital where the hip or knee replacement takes place would be held accountable for the quality and costs of care from the time of surgery through 90 days after discharge.

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