OVERVIEW
Over the last five years we have witnessed the proliferation of bundled payments from small pilot experiments to wide scaled payment programs across multiple conditions in both private and public payers. Medicare now has three active programs including the large-scale Bundled Payments for Care Improvement Initiative (BPCI), the Comprehensive Care for Joint Replacement Program (CJR) and the Oncology Care Model (OCM). The PTAC (Physician Technical Advisory Committee), a congressional appointed committee embedded in the MACRA legislation, is currently evaluating several physician focused bundled projects to facilitate clinicians to receive APM status. Qualified APMs receive the enhanced bonus on their fee schedule.
Most experts expect that under the new administration bundled payment programs will remain as a key strategy to support the transition out of Medicare fee-for-service. However until the HHS Secretary and/or the CMS Administrator make a definitive policy statement regarding bundled payment policy, the future remains somewhat speculative. On March 21, CMS delayed the expansion of the CJR model and the effective date of the newest kid on the block, the cardiac bundled payment program, until Oct. 1. Both these bundled payment programs are mandatory for certain hospitals. There is speculation that the new administration may have a preference for voluntary participation models. However, the delay doesn’t affect hospitals already deep into the CJR program that went live April 1.
Similar to the Medicare’s move to value-based payment models such as bundled payments, statewide programs involving Medicaid and public employee health benefits plans are also moving large volumes of public sector health care dollars away from feefor-service. Further, private sector health plans are increasing the scope and breadth of their bundled payment programs. Finally, providers are turning to employers for direct contracting arrangements.
The 2017 Bundled Payment Summit features keynote addresses from both policy makers andproviders including national hospital and physician thought leaders with real-life implementation experience. Given the growth in complexity of bundles this year’s Summit will focus on deeper breakthrough strategies to implement bundled payment arrangements with private and public sector payers as well as self-funded employers. In addition, focus will also include consumers and how to best engage them in bundled payment initiatives. Other topics include, bundles and MACRA, implementation case studies, data & analytics, risk arrangements, employer perspectives, transparency and how to synchronize ACOs and bundled payments.
For those interested in alternative payment models such as bundled payments and want to understand the intersection of bundled payments, MACRA and ACOs, this conference hosts more thought leaders and national experts than any other conference of its type.
LEARNING OBJECTIVES
- –Identify the challenges associated with statewide bundled payment implementations.
- –Understand best practices for analyzing data and reporting outcomes of bundled payment initiatives.
- –Examine and analyze various case studies of current implementations.
- –Understand the importance of the role transparency plays in initiatives.
- –Identify how to engage consumers in bundled payment initiatives.
- –Examine benefits and challenges associated with bundled payments in accountable care.
- –Understand alternative approaches for adjudicating bundled payments.
- –Explain the current issues related to insurance benefit design and bundled payment that must be considered for accurate payments.
- –Understand the importance of quality metrics for successful implementation of episode bundled payment.
- –Describe examples of quality measurement, including the key quality measurement domains (i.e., clinical, patient experience, safety, and outcomes).
- –Provide examples of quality metrics for certain episode payment bundles.
- –Understand the existing incentives in the current fee-for-service environment that exist for surgeons and other providers.
- –Clarify the new objectives that must be met to succeed in episode bundled payment (i.e., fewer complications, lower implant device costs, etc.).
WHO SHOULD ATTEND
- –Hospital CEOs and CFOs
- –Medical Analytic Specialists
- –Quality Improvement Executives
- –Managed Care Executives
- –Managed Care Contracting Experts
- –Orthopedic Chiefs of Staff
- –Surgeons
- –Service Line Executives
- –Health Plan Representatives
- –Medical Directors
- –Information Technology Vendors
- –Health Policy Makers
- –Academics
- –Physicians and Physician Organizations
- –Healthcare or Information Technology Media