Bundled Payments

Support to help you succeed in the era of bundled payments and episode-based reimbursement

Mandatory bundled payment programs from the Centers for Medicare & Medicaid Services (CMS) represent the first big step toward the shift to value-based care in the United States. The momentum behind bundled payments is not limited to Medicare reimbursement dollars, as Payers are also moving quickly toward the adoption of bundled payments and other alternative payment models.

CJR, AMI, CABG, SHFFT—and Beyond

The Comprehensive Care for Joint Replacement (CJR) bundled payment model is now in its second year, and penalties for providers begin July 1, 2017. Additionally, CMS recently announced updates to the CJR program and released the final rule for several new episode payment models:

  • Cardiac care episodes, including acute myocardial infarction (AMI), coronary artery bypass graft (CABG) and cardiac rehabilitation (CR)
  • The Surgical Hip and Femur Fracture Treatment (SHFFT) model, extending bundled payments in orthopedic care to non-elective acute fractures

The road to value based care

The time is now

Providers who develop an accurate and objective assessment of their current risks, gaps and opportunities now will be uniquely positioned to succeed under value-based reimbursement programs in 2017 and beyond. In spite of this, many acute inpatient care providers in the US report they are not adequately prepared with a clear path to success under bundled payment initiatives.

We can help

With robust data and analytics capabilities and a long history of helping clients succeed under episode-based payment models, Truven Health can help guide you through the transition to bundled payment programs successfully.

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