OR Manager - January 2018 - 27

Finances
Value-based care
Continued from page 21
Rehabilitation Incentive Payment Model
that were supposed to start in January.
" While CMS continues to believe
that bundled payment models offer opportunities
to improve quality and care
coordination while lowering spending,
we believe that focusing on developing
different bundled payment models and
engaging more providers is the best
way to drive health system change while
minimizing burden and maintaining access
to care. We anticipate announcing
new voluntary payment bundles soon, "
said CMS Administrator Seema Verma
in a statement.
Some healthcare providers welcome
the shift to a voluntary vs mandatory
approach, especially those who are reluctant
to switch from fee-for-service to
value-based payment models. Others
worry that these changes signal lack of
support for bundled payments.
One example of a facility that may
continue bundled payments on a voluntary
basis is Piedmont Athens Regional
Medical Center in Georgia, which was
designated as a CJR participating hospital.
Their bundled payment program,
which began in April 2016, quickly led
to a drop in use of post-acute facilities.
That's because of concerted efforts
by surgeons and nursing staff to reduce
the number of patients being discharged
to rehabilitation or SNFs.
Their cost reductions and improvements
in patient care has led to a
$107,000 bonus from Medicare for
meeting cost and quality targets.
What's ahead?
" While the pace of change will be slow
and probably uneven, there is no real
turning back from value-based care, "
Peters says. " Better performing organizations
recognize that the move to
VBC is inevitable. Such organizations
are straddling the current fee-for-serwww.ormanager.com
vice
model while preparing to shift to
a valued-based model in which clinical
outcomes and cost will drive financial
performance. "
At UMass Memorial Health Care,
goals for the future include streamlining
processes and implementing a program
to educate VNA and other outpatient
services about the specific needs of its
patient population, according to Wood.
" Our facility has expanded bundle payment
to total knees, total hips, and
spine, and we're currently looking at
other options, " she adds.
Wood's advice is to " always be on
the lookout to help identify those patients
that may not be on the pathway
so early intervention is a possibility " -
just one of many lessons learned on the
journey to improving quality of care. ✥
-Elizabeth Wood
References
Centers for Medicare & Medicaid Services.
CMS Bundled Payments for
Care Improvement Initiative Models
2-4: Year 3 Evaluation & Monitoring
Annual Report. Lewin Group.
October 26, 2017. https://downloads.cms.gov/files/cmmi/bpcimodels2-4yr3evalrpt.pdf.
Dickson
V. CMS may have overcorrected
in cancellation of cardiac
models. Modern Healthcare. October
19, 2017.
https://drivehealth.org/blueprint/.
https://innovation.cms.gov/initiatives/bundled-payments/.
https://innovation.cms.gov/initiatives/cjr.
https://www.cms.gov/Outreach-andEducation/Outreach/FFSProvPartProg/Provider-Partnership-EmailArchive-Items/2017-11-09-eNews.
html#_Toc497829713.
https://www.cms.gov/Newsroom/
MediaReleaseDatabase/
Fact-sheets/2017-Fact-Sheetitems/2017-11-30.html.
https://www.healthcare-informatics.
com/news-item/value-based-care/
survey-73-percent-physicians-preferfee-service-models.
https://www.strategyand.pwc.com/
media/file/Annual-Bundles-Survey2015-2016-Results.pdf.
Meyer
H. Bundled-payment joint replacement
programs winning over
surgeons. Modern Healthcare. October
7, 2017.
What's Missing
From Your Toolbox?
You just might find it on our website!
OR Manager's Toolbox is frequently
updated with new protocols, forms,
and guidelines-such as sample
preference cards and checklists-to
help you manage a safe, efficient
operating room.
Take a moment to see what's there!
Visit www.ormanager.com and click
on " Free Toolbox. "
Related Content
For more on this topic, see these OR
Manager articles:
* Orthopedic PSH a prime model for
value-based care-Part 1 (August
2017; 16-19)
* Orthopedic PSH a prime model for
value-based care-Part 2 (September
2017; 22-23)
* Bundled payments: Part and parcel
of value-based care (October
2016; 1, 13-16)
* Value-based payment raises quality
stakes in patient care (May
2016; 4-5)
* Two hospitals face value-based
payment - which one does your
OR resemble? (April 2016; 23-25)
* Deadline looms for CMS orthopedic
bundled care program (October
2015; 22-23)
OR Manager | January 2018 27

https://www.strategyand.pwc.com/ http://www.ormanager.com https://down http://loads.cms.gov/files/cmmi/bpci https://www.drivehealth.org/blueprint/ https://innovation.cms.gov/initia https://innovation.cms.gov/initia https://www.cms.gov/Outreach-and https://www.cms.gov/Newsroom/ https://www.healthcare-informatics http://www.ormanager.com

OR Manager - January 2018

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