August 24, 2017

Voluntary bundled-payment models shifting to outpatient procedures

By: Judy Mathias

Editor’s Note

Though the Centers for Medicare & Medicaid Services (CMS) is rolling back mandatory bundled-payment programs, it is expected to release more voluntary, outpatient-focused programs, which shifts power from hospitals to physicians, the August 21 Healthcare Finance News reports.

Physician-focused does not require a hospitalization, which creates a complete shift in the dynamic of who controls and who is the supplier. Currently the physician is the supplier because hospitals control which physicians they want to work with. Under a physician-focused model, the facility becomes the supplier.

In this new model, hospitals and physicians will have to collaborate to save money on surgical supplies because all members of the care team have an incentive to cut back on costs, the report says.

New bundled payment models will shift power from hospitals to physicians, according to the Altarum Institute’s vice-president and director of the Center for Payment Innovation. This week, the Centers for Medicare and Medicaid Services released a proposed rule cancelling mandatory programs for care coordination for certain episode payments and for cardiac rehabilitation.

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