At Hillcrest Medical Center in Tulsa, Okla., one of five hospitals nationwide to participate in the Medicare pilot project, Orthopedic Surgeon Yogesh Mittal, MD, said he hasn’t had any problems getting his share of the bundled payment from the hospital, as many physicians have feared.
For the a knee replacement that Dr. Mittal performed, Medicare made a bundled payment to the hospital and physician of $13,211, about $450 less than normal, and paid the patient $271 for choosing the hospital.
The current pilot covers orthopedic and cardiac surgery payments at Hillcrest and Baptist Health System in San Antonio and is expected to start at three more hospitals in Denver, Albuquerque and Oklahoma City this year.
Legislation in Congress would expand the program if it can be shown to attract more patients to participating hospitals.
A CMS bundling pilot for coronary bypass surgery in the mid-1990s saved Medicare $42.3 million over three years, and while participating hospitals did not see an increase in patient volume, it was probably because patients in that study were not getting incentive payments.
Read USA Today’s feature on bundling payments for physicians and hospitals.
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.
