Bundled Payments on the Horizon: New Medicare Payment Program

On January 20, 2018, the Trump administration announced it was starting a new Medicare payment program. The New York Times reported that under the new initiative, “…Medicare will make a single ’bundled payment’ for nearly all the services provided in a 90-day period to certain Medicare patients who are admitted to a hospital or have certain outpatient medical procedures.”

Implementation of the new program will present a variety of challenges for healthcare provider organizations, namely:

• Care Process Design and Transformation
• Cost Analysis
• Clinical Quality Outcome Measurements

Bundled payment models will require providers (hospitals, healthcare systems, physicians, post-acute care providers) to:

• Improve their understanding of their care processes and procedures
• Understand how to transform those care processes so that they reliably deliver high value, i.e., quality per unit of cost,
• Be able to measure the underlying costs of care delivery to ensure an adequate margin within a bundled payment model
• Be able to demonstrate that quality outcomes are not impaired through cost-cutting measures.

Coker Group has experienced advisors ready to assist you with bundled payment care design and implementation and the accompanying challenges. We have worked with hospitals and practices (both large and small) in this area and are prepared to help you operate successfully in this novel payment model.