Dive Brief:
- CMS is moving on to a new stage in its Bundled Payments for Care Improvement effort, offering four payment models to participating hospitals.
- Of the four models model number four is the most "advanced," in that hospitals agree to an upfront price on specific DRGs, and CMS pays that specific bundled price to the hospital. The hospital then pays physicians and caretakers. CMS is still paying fee-for-service reimbursement for the other models.
- 62 hospitals are participating in be BPCI's Model 4, which is itself in its first phase; hospitals in Model 4 are using the first phase to prepare to assume financial risk.
Dive Insight:
The BPCI is a very interesting development, as it takes the hospitals in a direction they're likely to go and need to understand. Of course, with just 62 participants, we're still looking at a very small slice of hospitals in the U.S., and it's not clear how quickly other acute care hospitals will get to this stage where they can safely assume financial risk themselves. But the program should generate some interesting data if nothing else, perhaps information that will help make it feasible for nonparticipating hospitals to get on board. I'm sure that's just what CMS had in mind.