Fee-for-service is being swept aside by the value-based payment model, with bundled Medicare payment programs serving as the broom. And it is already kicking up dust within the healthcare industry.
"People are comfortable with fee-for-service – they know how to do it and bundled payments are a totally different approach," said Cathy Ball, director of the Bundled Payments Initiative at Lahey Health in Burlington, Mass.
To help drive the transition, Lahey Health kicked off a pilot program focused on striking a balance between costs and outcomes, while promoting effective communication among providers across the entire healthcare continuum, Ball said.
The Centers for Medicare and Medicaid Services' Bundled Payment Care Improvement is a key component of the value-based payment programs proposed in the Affordable Care Act of 2010 and is being touted as a viable methodology for providing high quality patient care at a more affordable price.
To gauge its effectiveness, the CMS Medicare and Medicaid Innovation (CMMI) unit is more than two years into piloting four models proposed within BPCI. CMS has already implemented the five-year mandatory total joint arthroplasty bundle in many areas of the country and more are expected.
Lahey Health is one of the pilot sites, with Ball heading up the initiative at the organization. The key to success with the new program, she said, is significant collaboration between clinicians and the IT team.
Concern among healthcare providers toward bundled payments stems from a natural resistance to change and, perhaps, skepticism about a dramatically different revenue matrix.
Ball understands this reticence, but is confident that bundled payments are a step in the right direction.
"We need to improve the process of handing the patient over to the next care setting in order to ensure the patient's care ends up with the appropriate outcomes all the way down the line," she said.
Ball will discuss lessons learned from taking part in the CMMI pilot during the HIMSS17 session, "What's All the Fuss About Bundled Payments?" schedule for Thursday, Feb. 23, at 12:00 PM EST in Room 204A.
HIMSS17 runs from Feb. 19-23, 2017 at the Orange County Convention Center.