We recently posted about CMS kicking off their first round of Bundled Payments for Care Improvement (BPCI) initiative, a new payment model considered a middle ground between fee for service reimbursement and capitation where providers are paid a “lump sum” per patient (Click here to read that post).
The following explains the first defined model of care:
Retrospective Acute Care Hospital Stay Only: Defined as an inpatient stay in an acute care hospital. Medicare would pay the hospital a discounted amount based on rates fixed under the Inpatient Prospective Payment System that has been used in the original Medicare program. Medicare would continue paying physicians for each service but in special circumstances, hospitals and physicians would be able to share gains from the providers’ care redesign efforts.
Stay tuned to our blog to learn about the other models! And, if you have any questions, concerns, or want to learn more about bundled payment options, please contact us at (203) 294-6659.