August 23, 2011: Stakeholder Conference Call announcing the Bundled Payments for Care Improvement initiative.
The HHS Assistant Secretary for Policy and Evaluation (ASPE) has conducted several research projects in the area of Medicare acute and post acute care episodes. The reports model the impact on potential payment bundles, provide cross-sectional and longitudinal analysis, examine differences in payments by geographic area using standardized payments, and analyze changes in post acute care use based on different episode definitions.
- The first ASPE report reflects 18 sample episode definitions.
- The second ASPE report reflects a modified sub-set of those episodes.
The following two chart books provide additional data on the implications of different episode definitions. The Center for Medicare and Medicaid Innovation is making these chart books available to Bundled Payments for Care Improvement applicants as a resource, but applicants should propose their own episode definitions in accordance with the parameters outlined in the Request for Applications.
- Analysis of Post Acute Care Episode Definitions File - This original chart book was so large it presented downloading difficulty for some visitors. Therefore, the original chart book has been divided into nine smaller files below for easier accessibility:
|Part 1 (PDF)||Part 2 (PDF)||Part 3 (PDF)|
|Part 4 (PDF)||Part 5 (PDF)||Part 6 (PDF)|
|Part 7 (PDF)||Part 8 (PDF)||Part 9 (PDF)|
Contractual Considerations (PDF) – A resource document that analyzes the issues related to contracts and agreements in an environment where hospitals, physicians, and other providers will interact in significantly new ways. Toward that end, this document describes the means of establishing bundled payment specific components of contracts among organizations, preparing these organizations to receive bundled payments from CMS or other payers. The Center for Medicare and Medicaid Innovation is making this analysis available to Bundled Payments for Care Improvement applicants as a resource, however the views, opinions and/or findings contained in this document are the authors’ own and do not constitute any official government position, policy or decisions.
Health Information Technology (PDF) – A resource document to help organizations evaluate their information technology (IT) capabilities as they consider participating in a bundled payment program. Toward that end this document presents a discussion of IT capabilities associated with bundled payment success, whether implementing a bundled payment arrangement with CMS or a other payers. The Center for Medicare and Medicaid Innovation is making this analysis available to Bundled Payments for Care Improvement applicants as a resource, however the views, opinions and/or findings contained in this document are the authors’ own and do not constitute any official government position, policy or decisions.
Case Studies (mitre.org) – A series of case studies that describe what organizations have done to develop the capabilities necessary to deliver cost-effective care in a setting where the organization bears financial risk for that care. The Center for Medicare and Medicaid Innovation is making these studies available to Bundled Payments for Care Improvement applicants as a resource, however the views, opinions and/or findings contained in this document are the authors’ own and do not constitute any official government position, policy or decisions.
Accelerated Development Learning Session (ADLS) Webinar Series: Bundled Payments
ADLS #6: Building an Effective Gainsharing Program – April, 6, 2012
Faculty will review key components of gainsharing program design and administration, providing personal lessons learned from the Medicare Hospital Gainsharing Demonstration, and examples of how that model and others could operate within varied clinical areas and organizational structures. Presentations will emphasize methods to ensure program effectiveness in incentivizing behavior change, credibility with all stakeholders and multi-year sustainability.
Bundled payments necessarily entail allocation of a single source of dollars, or a reconciled budget, to disparate providers. In the mid-90s, disputes over how to allocate monies contributed to the relative failure of a number of PHOs. In this webinar, Faculty will outline contractual structures and provisions to ensure that payments are consistent with the expectations of the participants. Faculty will not address Stark, anti-kickback or gainsharing issues.
Faculty will review criteria for selecting conditions or procedures to target for bundled payment, discuss requirements and options for episode definition for those targets, and provide examples of clinical and operational strategies to maximize improvement in care quality and efficiency within defined episodes.
ADLS #3: Data-Driven Continuous Quality and Efficiency Improvement – February 21, 2012
Faculty will share principles and techniques for engaging quality leaders and physician champions, along with models for data exchange to support a continuous organizational effort to achieve better health, better care and reduced costs through improvement.
ADLS #2: Transform Care Today: Strategies and Tactics Across the Continuum – February 14, 2012
Faculty will share their insights on topics including strategies to develop physician leadership, keys to success in care redesign, the critical hand-off from acute to post-acute care, how acute providers can successfully work with post-acute providers and how post-acute providers can lead the way.
Implementing Bundled Payment: Ready, Set, Go – January 18, 2012
For business and clinical representatives from organizations or state agencies that are developing bundled payment programs for either private- or public-sector populations.
Webinars: Technical Assistance and Program Information
The CMS Innovation Center will be hosting a technical assistance webinar on the use of the Bundled Payments for Care Improvement online application portal on Wednesday, May 9, 2012 from 4:00-5:30 PM EDT.
BPCI Online Application Portal Goes Live – May 3, 2012
The CMS Innovation Center is pleased to announce that the Bundled Payments for Care Improvement Initiative (BPCI) Online Application Portal is now available for use by applicants.
Application Guidance for Models 2-4 of BPCI – April 19, 2012
The CMS Innovation Center is pleased to announce a webinar discussing our Application Guidance document. This webinar will highlight key areas from the document discussing what a strong application to the BPCI initiative should include. We encourage you to review the Models 2-4 application questions and the new Application Guidance document, all available on our website, prior to this webinar.
Distinguishing Between Applicant Roles – March 8, 2012
Designed to ensure that all applicants to Models 2-4 of BPCI have a clear understanding of the three different roles an applicant must choose from when applying to this initiative. The applicant roles are linked to the applicant's partner types, as well as to how the applicant decides to partner with these Bundled Payment participating organizations.
Model 3 Deep Dive – February 9, 2012
Designed for Post-Acute Care (PAC) providers seeking additional information about how Model 3 works and a better understanding of the opportunities for PAC providers within the Bundled Payment for Care Improvement (BPCI) initiative.
Webinar Series on Data Files – February 13, 2012 through February 17, 2012
These webinars will provide information about understanding and working with the Limited Data Sets being provided for the Bundled Payments for Care Improvement initiative.
Resources on Using CMS Historical Medicare Claims Data Provided Through This Initiative:
Frequently Asked Questions regarding the data files being provided are now available.
Metadata on the CMMI LDS files (.zip) being provided is now available.
Listing of the sort order (.zip) for files being provided is now available.
Listing of the files sizes (PDF) that will be provided for each HRC is now available.
Access to data dictionaries for each of the corresponding seven files being provided can be accessed below:
- Denominator File (PDF)
- Carrier File (PDF)
- DME File (PDF)
- Inpatient File (PDF)
- Outpatient File (PDF)
- Home Health Agency File (PDF)
- Skilled Nursing Facility File (PDF)
Technical Assistance Conference Call Series
The CMS Innovation Center is pleased to present, in conjunction with the Research Data Assistance Center (ResDAC), a series of conference calls to discuss answers to questions regarding historical claims data analysis for the Bundled Payments for Care Improvement initiative. These data technical assistance conference calls are scheduled for each Wednesday, March 14th through June 27th, from 12:00 to 1:00 PM Eastern Time.
In order to access these calls, please use the following phone number and meeting ID number.
- Phone number: 1-877-267-1577
- Meeting ID number: 5510
On this call, ResDAC and the CMS Innovation Center will respond to questions they have previously received via email, which will be emailed out to our listserve the day before the call. After these question have been answered, the call will be opened for discussion of these topics and you will have the opportunity to ask and receive answers to questions in a live forum. We encourage you to submit questions in advance via email, through the process described below, as ResDAC will continue to prepare materials for this and future calls based on the question they have received.
Please visit the ResDAC website to read the FAQs they have prepared, which are the primary source of information on historical claims data analysis for this initiative.
We will utilize this listserv to distribute the call-in information and list of topics, so please encourage others on your team to sign up to receive Bundled Payments email updates to ensure they stay informed.
How to submit questions on historical claims data
For this initiative we will be accepting questions via email only. In your email please reference 'Bundled Payments' in the subject line and please include both your DUA number and request ID.
- For technical assistance with opening the files and initial file processing, please email Buccaneer at CMSdata@vangent.com.
- For technical assistance related to the contents of the files, please email ResDAC at ResDAC@umn.edu.
- For all other questions, as well as all policy questions, please email us at BundledPayments@cms.hhs.gov.
If you are uncertain where to send your specific question, do not hesitate to email us at BundledPayments@cms.hhs.gov and we will ensure your questions goes to the correct organization.