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2018 In The News

Providers partner with payers for bundled payments
Despite the elimination of mandatory bundled payments by the Centers for Medicare and Medicaid (CMS), commercial insurers are investing in this model based upon the positive results they’ve seen from the CMS demonstration models and their own trial experiences. Bundled payment models shift financial and clinical accountability to a single provider-led organization that takes [...] Read more

Commercial payers benefit from bundled pricing
An editorial by Shane Wolverton. As commercial payers seek strategies to lower costs and improve care quality, they are increasingly paying closer attention to bundled payments. While many payers express concerns about the impact of recent regulatory reversals that removed mandatory requirements for bundled payments, the benefits of bundled pricing still resonate strongly [...] Read more

Bundled Pricing: Cost Containment, Better Outcomes Attract Commercial Payers
( – While mandatory bundled payments have been scaled back by the Centers for Medicare and Medicaid (CMS), commercial insurers are starting to offer bundled reimbursement programs to their customers. Market analysts see government support of voluntary bundles for payment initiatives as a signal that this innovative strategy is here for the long-term. [...] Read more

Demonstrating High Quality Care Becomes Paramount in the Bundled Payment Models
The Centers for Medicare and Medicaid Services’ (CMS) cancellation of the mandatory payment bundles for cardiac care, surgical hip and femur fracture treatment in late 2017 is expected to be replaced in 2018 with a voluntary program, called the Bundled Payments for Care Improvement Advanced (BPCI). CMS also cancelled the cardiac rehabilitation incentive payment model […] Read more

Building an ERM Framework for Value-Focused Health Care
Healthcare organizations have long employed various approaches to risk management to prepare for risks that are unique to healthcare delivery settings, such as adverse events that pose harm to patients, visitors, and employees. However, with the advent of the Affordable Care Act (ACA), which mandates the tethering of clinical and financial operations together into value-based [...] Read more
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