Bundled Payments for Care Improvement Learning & Resources Area

General Resources

 

ASPE Reports 

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.

Definitions 

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.

 

Previous Webinars

 

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.

ADLS #5: Contractual and Governance Issues among Providers in Bundled Payments – March 22, 2012

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.

ADLS #4: What to Pack in Your Bundle: Episode Selection, Definition and Clinical Management for Care Improvement – March 13, 2012

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 ImprovementFebruary 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.



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