CMS chose Baptist Health System of San Antonio, Tex.; Hillcrest Medical Center in Tulsa and Oklahoma Heart Hospital in Oklahoma City, Okla.; Exempla Saint Joseph Hospital in Denver, Colo., and Lovelace Health System in Albuquerque, N.M., for the demonstration.
The program tests the use of bundling Medicare Part A and Part B payments for episodes of care provided during a patient hospital stay, using a single global payment shared both by doctors and hospitals on 28 high volume cardiac and nine orthopedic services and procedures. Medicare now pays hospitals and doctors separately for those services.
The demonstration is intended to align incentives and improve the quality and continuity of care by sharing risk and reward between providers, adopting clinical pathways and gainsharing, another step in the ‘value-based’ purchasing model espoused by the Bush administration.
“We are always looking for ways to improve Medicare, both in efficiency and in better care for patients, and this new demonstration promises to be a big step in that direction,” said CMS Acting Administrator Kerry Weems. “CMS expects to demonstrate how to better coordinate inpatient care, and achieve savings in the delivery of that care that can ultimately be shared between hospitals, physicians, beneficiaries, and Medicare.”
CMS announced the demonstration project in May 2008 and said it would begin implementing the three-year program in October.
Learn more about the CMS Acute Care Episode demonstration project.
