The challenges and benefits of bundled payments and risk-based arrangements is one of the biggest issues facing the healthcare field. Kelly Price, DataGen’s Vice President and Chief of Healthcare Data Analytics, and Stephanie Kovalick, Chief Strategy Officer at Sage Growth Partners sat down to help shed some light on ways to succeed with bundled payments and risk-based payment models. Read more about this conversation in our new installment, “The Future of Payment Reform: How can providers, patients, and payers benefit—and who bears the burden? ” 

Launched on April 1, 2016, CJR is the first mandatory bundled payment program from CMS.  Affecting more than 750 hospitals in 67 markets, CJR creates a host of new challenges and opportunities for participants. Read the article to learn more about the program and prepare for the initial data release .

In July 2015, the Centers for Medicare and Medicaid Services (CMS) proposed its Comprehensive Care for Joint Replacement (CCJR) payment model, a pilot bundled payment program for the most common inpatient surgeries for Medicare beneficiaries—hip and knee replacements, known as lower extremity joint replacements (LEJRs). While CMS’ increasing interest in bundled payments has been apparent, the announcement of this mandatory initiative was a surprise to many, given that the Bundled Payments for Care Improvement (BPCI) demonstration program, initiated in 2013, is still in its early stages.  CCJR would be mandatory for hospitals in 75 Metropolitan Statistical Areas (MSAs). This white paper examines the top ten things every hospital executive should know about the proposed CCJR program, its relationship to the BPCI demonstration, and the implications of this model for other innovative payment models.  Download White Paper

What is the most cost-effective post-acute care setting for rehabilitation after a medical or surgical hospital stay—an inpatient rehabilitation facility (IRF) or a skilled nursing facility (SNF)?  It is widely assumed that rehabilitative care in an IRF may be more effective because of its higher-intensity programs, lower lengths of stay, and fewer readmissions.  But, is this the full story?  Download this article

For 30 years, Medicare's hospital Inpatient Prospective Payment System has used DRGs to account--or risk adjust--for the differences in the cost of care for clinically complex patients.  By creating a direct link between reimbursement and outcomes, pay-for-performance adds a new layer to the issue of risk adjustment. Download this article