5 Ways to Cut Costs in a Bundled Payment Program

Recently, the Centers for Medicare and Medicaid Services mandated bundled payments for total hip and knee replacement surgeries. This rule, known as the Comprehensive Care for Joint Replacement (CJR) model, holds hospitals responsible for the total quality and cost of patient care across an entire treatment episode. Designed to help Medicare beneficiaries receive better quality care, the program puts the burden on hospitals to drive cost savings and patient satisfaction from admission through recovery.

The challenge? Most spending takes place after the patient leaves the hospital, in post-acute care and readmissions. In fact, the American Hospital Association estimates that a whopping 37 percent of Medicare spending on joint replacement episodes takes place after surgery. Additionally, a recent Institute of Medicine study found that post-acute care was the single biggest factor driving geographic variation in Medicare per-beneficiary spending.

So how can healthcare providers reduce costs and improve care in the post-acute setting? Below are five tips:

1.     Refer patients to less-costly home health care settings versus a rehabilitation hospital or nursing facility, if it makes sense for the patient

2.     Establish relationships with post-acute care providers such as rehab facilities that have a history of good outcomes and a willingness to partner on performance outcomes

3.     Balance the costs and benefits of using a lower-cost setting against potential problems with readmissions in light of the health history of the patient

4.     Invest in personnel to coordinate care transitions, including staff to navigate transitions and teams of clinicians to conduct regular rounds in nursing facilities to track patients

5.     Invest in systems that allow patients to more fully own their recovery through coaching and improved communications

While bundled payments for orthopedics are top of mind today, other fields such as cardiology and oncology are also evaluating the model. Now’s the time to prepare. To learn more about CJR and how you can be successful, join our webinar next Tuesday, August 9, at 2pm ET. We’ll give you more details on CJR and bundled payments, explain the role of care coordination, and share how ViiMed can help. Hope you can make it!