In the program, which is also known as Medicare Part C, people are enrolled in health plans run by private insurers, but the Medicare system pays the plans a fixed amount each month for the customers.
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Not unexpectedly, President Barack Obama has nominated Andy Slavitt, now serving as acting administrator of the Centers for Medicare & Medicaid Services, to fill the role as administrator. However, the hospital would be held accountable for the quality and costs of care for the entire episode – from the time of the surgery through 90 days after discharge.
In 2013, an estimated 400,000 inpatient primary procedures led to $7 billion in spending for hospitalizations, noted an agency press release.
Tricia Neuman, a senior vice president at the Kaiser Family Foundation and a Medicare expert, said the experiment is consistent with the administration’s ongoing push to improve the quality of care and lower costs, and could greatly benefit patients.
The targeted areas include over 800 hospitals, ranging from major cities like New York and Los Angeles, to smaller areas such as Lubbock, Texas, and Flint, Michigan, said CMS Chief Medical Officer Patrick Conway. The aim is to improve the healthcare by awarding for good quality of care than volume of services.
Depending on the quality, the hospital may receive an additional payment or have to pay Medicare. AMGA members encompass all models of organized systems of care in the healthcare industry, including: physician-owned, independent group practices, integrated delivery systems, hospital-affiliated medical groups, independent practice associations (IPAs), academic and faculty practices, accountable care organizations, and high-performing health systems. “The time has come to work together productively to ensure all Americans have the security of health care coverage, and I look forward to Mr. Slavitt’s timely confirmation as a part of that effort”.
Bundling the payments is an incentive for patient care, a patient-centered approach, Burwell said. “And it’s what we hear that many doctors and providers want – to be able to give the best care possible to their patients”.
Some doctors, hospitals and large employers have already forged ahead with this idea of bundled payments for heart, spine and transplant surgeries.
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“We know this will be a change, we would ask providers to learn new approaches”, she said. Both the public and stakeholders are invited by the CMS to offer input during the 60-day comment period.
