Under the Bundled Payments for Care Improvement initiative, organizations will enter into payment arrangements that include financial and performance accountability for episodes of care. These models may lead to higher quality, more coordinated care at a lower cost to Medicare.
In Model 2, the episode of care will include the inpatient stay in the acute care hospital and all related services during the episode. The episode will end either 30, 60, or 90 days after hospital discharge. Participants can select up to 48 different clinical condition episodes.
Background
Medicare currently makes separate payments to providers for the services they furnish to beneficiaries for a single illness or course of treatment, leading to fragmented care with minimal coordination across providers and health care settings. Payment is based on how much a provider does, not how well the provider does in treating the patient.
Research has shown that bundled payments can align incentives for providers – hospitals, post acute care providers, doctors, and other practitioners – to partner closely across all specialties and settings that a patient may encounter to improve the patient’s experience of care during a hospital stay in an acute care hospital, and during post-discharge recovery.
On January 31, 2013 Phase 1 participants were announced. Phase 1 (January-July 2013), also referred to as the “no risk preparation” period, is the initial period of the initiative, where CMS and participants prepare for implementation and assumption of financial risk. All candidates included in Phase 1 submitted a final list of their episodes and planned partners in December 2012.
The “risk-bearing implementation” period, Phase 2, is expected to begin in July 2013. Those participants in Phase 1 of Models 2, 3, and 4, that are ultimately approved by CMS and decide to move forward with implementation and assume financial risk, may enter into a Bundled Payments for Care Improvement Model agreement with CMS and begin Phase 2 of the Model.
Phase 2 is expected to begin in July 2013. The beginning of Phase 2 would mark the beginning of the performance period, or risk-bearing period.
Model 2 participants
- Alegent Health Mercy Hospital (Council Bluffs, IA)
- Banner Del E. Webb Medical Center (Sun City West, AZ)
- Banner Heart Hospital (Phoenix, AZ) This participant is a convener of health care facilities in AZ
- Borgess Medical Center (Kalamazoo, MI)
- Doylestown Hospital (Doylestown, PA )
- First Health Moore Regional Hospital (Pinehurst , NC)
- Lodi Memorial Hospital Association, Inc. (Lodi, CA)
- Mercy St. Vincent Medical Center (Toledo, OH)
- Montefiore Medical Center (Bronx, NY)
- The Rutland Hospital (Rutland, VT)
- Silver Cross Hospital and Medical Centers, Inc (New Lenox, IL)
- St. Mary Medical Center (Long Beach, CA )
- Novato Community Hospital (Novato, CA)
- SwedishAmerican Hospital (Rockford, IL)
- University of Alabama Hospital (Birmingham, AL)
- Winthrop-University Hospital (Mineola, NY)
- Saint Bernardine Medical Center (San Bernardino, CA) This participant is a convener of health care facilities in CA
- Banner Desert Medical Center (Mesa, AZ)
- Banner Estrella Medical Center (Phoenix, AZ)
- Banner Thunderbird Medical Center (Glendale, AZ)
- Baptist Medical Center (San Antonio, TX)
- Bayonne Medical Center (Bayonne, NJ) This participant is a convener of health care facilities in NJ
- Catholic Health Initiatives (Englewood, CO) This participant is a convener of health care facilities in CO, KY, NE, TN, AR
- Catholic Health Services of Long Island (Rockville Centre, NY) This participant is a convener of health care facilities in NY
- Community Hospital of the Monterey Peninsula (Monterey, CA)
- Cleveland Clinic Health System (Cleveland, OH)
- Harrington Memorial Hospital (Southbridge , MA)
- Health Choice Preferred Accountable Care LLC (Franklin, TN) This participant is a convener of health care facilities in AZ
- Health Choice Utah Accountable Care LLC (Franklin, TN) This participant is a convener of health care facilities in UT
- Jordan Hospital, Inc. (Plymouth, MA)
- Kent Hospital (Warwick, RI)
- Maine Heart Center (Portland, ME) This participant is a convener of health care facilities in ME
- Meriter Health Services, Inc. (Madison, WI)
- Methodist Health Partners (Omaha, NE) This participant is a convener of health care facilities in NE, IA
- NaviHealth, Inc. (Brentwood, TN) This participant is a convener of health care facilities in NM, OK, TN, NJ, CA
- North Shore LIJ Health Care Inc (Great Neck, NY) This participant is a convener of health care facilities in NY
- Remedy Partners, Inc (Darien, CT) This participant is a convener of health care facilities in PA, CT, NJ, NY, RI, MA
- Presence Health Network (Chicago, IL) This participant is a convener of health care facilities in IL
- Saint Francis Health System (Tulsa, OK) This participant is a convener of health care facilities in OK
- Seton Health Alliance, Inc. (Austin, TX) This participant is a convener of health care facilities in TX
- Signature Health Services, Inc. (Saint Louis, MO) This participant is a convener of health care facilities in MO, KS
- St Vincents Healthcare (Jacksonville, FL) This participant is a convener of health care facilities in FL
- St. Mary Medical Center Langhorne PA (Langhorne , PA)
- Touchstone Health (White Plains, NY) This participant is a convener of health care facilities in NY, NJ
- Vanguard Health Chicago (Chicago, IL) This participant is a convener of health care facilities in IL
- VHS of Michigan - Detroit Medical Center (Detroit, MI) This participant is a convener of health care facilities in MI
- Wyoming Medical Center (Casper, WY)
- CoxHealth (Springfield , MO) This participant is a convener of health care facilities in MO
- Association of American Medical Colleges (Washington, DC) This participant is a convener of health care facilities in PA, NC, TN, LA, IL, NY, NJ
- Estes Park Institute, at Horty, Springer & Mattern (Pittsburgh, PA) This participant is a convener of health care facilities in CA, NY, OH, PA, IL, NC, MN, NH
- Geisinger Clinic (Danville, PA) This participant is a convener of health care facilities in PA, VA, MA, MN, ND, TN
- Henry Ford Physician Network (Detroit, MI) This participant is a convener of health care facilities in MI
- Precedent Health (Brentwood, TN) This participant is a convener of health care facilities in TN
- Premier, Inc. (Charlotte, NC) This participant is a convener of health care facilities in NC, MA, MT, GA, IL, IN, FL
- SSM Managed Care Organization (St. Louis, MO) This participant is a convener of health care facilities in MO
Additional Information
