What can you do while CMS decides how to handle the mandatory program? As the healthcare community continues its march away from fee-for-service models, bundled payment initiatives have risen in popularity—thanks in no small part to their ability to fuel cost savings and significantly improve care outcomes. The Centers for Medicare and Medicaid Services (CMS) issued an interim final rule in March that delays implementation of the new bundled payment model for heart attack and cardiac bypass surgery services; expansion of the existing Comprehensive Care for Joint Replacement bundling model; and implementation of a new cardiac rehabilitation incentive payment model, from July 1 to October 1, 2017. Prior to the interim rule, CMS’ push forward on bundled payments focused the industry on episodic efficiency. The delay has pushed these initiatives back three months and, as DataGen’s Vice President, Kelly Price recently explained, is causing confusion and worry among participants.

Another round of major healthcare financial cuts is possible—and their impact could be devastating. As healthcare policymakers and analysts try to mitigate the high cost of healthcare in the United States, payment reform is already making an impact on the way provider organizations do business. DataGen recently released projections revealing the impact of cuts made in Medicare payments to hospitals and hospital systems across the nation over the last 16 years. These cuts were partially offset by the coverage increases under the Affordable Care Act (ACA). As the new administration turns its attention to healthcare, however, there are more potential cuts on the table. If these cuts are enacted—and if done so while the coverage expansion provided by the ACA is repealed or changed—healthcare organizations face a major risk of a massive decrease in funding.

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? ” 

As we look ahead to 2017—a year that’s sure to bring changes to the way healthcare is delivered under the new Trump Administration—Kelly Price, DataGen’s Vice President and Chief of Healthcare Data Analytics, sat down with Stephanie Kovalick, Chief Strategy Officer at Sage Growth Partners, to provide expert perspective on the current and future states of payment reform. Download 

The healthcare industry is in a state of quiet anticipation as we await the second data feed from the Centers for Medicare and Medicaid Services’ (CMS) Comprehensive Care for Joint Replacement (CJR) bundled payment model. Participants still have a lot of questions?  Will the program help hospitals deliver better accountability for care? Will care be coordinated more effectively? Is it going to help reduce costs—and if it does, for whom?  Learn more

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 .

Announced by the CMS in January 2015, OCM is one of the most recent programs in a litany of new experiments.   Simplifying and organizing the complex data and policy component of this program requires specialized expertise in healthcare analytics. Read about DataGen's recent work related to the OCM in Achieving Data-Driven Success Under the OCM , which identifies four critical areas data analytics will need to address for any bundled payment model. Download the article .