The Centers for Medicare & Medicaid Services’ Bundled Payment for Care Improvement and Comprehensive Care for Joint Replacement initiatives will be important tests of how well Medicare bundled payment efforts can encourage hospitals, physicians, and post-acute care providers coordinate care to lower spending and improve quality and the patient experience, according to an issue brief released today by the AHA. “Total joint replacement is a high-volume procedure with relatively low spending variation, making it an ideal procedure for testing mandatory bundled payment,” the report notes. “In contrast, other common medical conditions like [congestive heart failure, chronic obstructive pulmonary disease], pneumonia and sepsis have more heterogeneous patients, less well-defined clinical protocols and greater spending variation. Several hundred BPCI providers have elected to take risk for these conditions and documenting their experience will be important.” The report describes the evolution of bundling within the Medicare program; the opportunities bundling creates for hospitals and post-acute care providers; the challenges providers have encountered in recent initiatives; the issues providers should consider when entering a bundled payment program; and policy considerations associated with a broader expansion of bundling initiatives in Medicare. The AHA today held a members-only webinar on strategies for redesigning care processes and workflows for success in bundled payment systems. To listen to a replay of this and other webinars in the AHA series on bundled payment best practices, visit www.aha.org/bundling.

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