On the morning of April 1, hospital executives in 800 hospitals in 67 selected market service areas across the U.S. will wake up to a new model of orthopedic bundled pricing. The pending implementation of CMS’s Final Rule for the Comprehensive Care for Joint Replacement (CJR) model will force business…
Our healthcare system today is broken in large part because of how we pay for it. Our fee-for-service legacy gives providers an incentive to deliver as many exams, tests, and treatments and fill as many beds as possible. But as we know, piling on services does not equate to high-quality…
The New Year brings a big decision for the more than 6,600 providers newly enrolled in Medicare’s Bundled Payments for Care Improvement (BPCI) program. If you’re one of these new BPCI participants, do you assume the risk of bundled payment for at least one care episode or drop out of…
With healthcare costs now claiming nearly 20% of GDP and quality lagging behind benchmarks, the urgent need to ensure better care at lower cost is increasingly plain to healthcare leadership. Providers at all levels need to begin the shift from a volume-based model to a value-based one that offers the…
Hospitals face profound operational and cultural challenges in meeting the demands of value based reimbursement, reference pricing and transparency. As they take on more risk and focus on outcomes based performance, Boards as well will struggle with the need for transformational change — what it means for their organization and…
Bundled pricing represents an alternative approach to fee-for-service that shifts the risk of extraordinary costs from payers to providers, and it creates incentives for providers to make cost effectiveness a factor in clinical decisions. Both of these outcomes are attractive to payers, who increasingly have an interest in containing healthcare…
