Bundled Payments

WEDI Releases Two Key Industry White Papers Focused on Issues Impacting Current Health Care Climate | PRWeb | 9/10/2020

WEDI Releases Two Key Industry White Papers Focused on Issues Impacting Current Health Care Climate Share Article Advisor to HHS releases latest industry resources that offer health systems guidance on navigating incorrectly routed payments; value-based payment models “Incorrectly Routed Payments And Remittance Advice” offers guidance for payers and providers on situations that occur when electronic healthcare claim payments and/or remittance advice are routed to a receiver incorrectly, potential …

Why Dr. Anthony Romeo joined DuPage Medical Group and where orthopedics is headed | Beckers Spine Review | 9/10/2020

… problems. We continue to have significant fee-for-service care throughout healthcare, which does not provide the best environment to encourage value-based care. We have move to some alternative payment models such as bundled payments , but this method typically lacks sustainable incentives. Bundled payments can have the effect of reducing a specific episode of care, but they are not built to eliminate less successful surgeries and it doesn’t necessarily …

Value-based Health Care Services Market: Rapid development in value-based health care services acts as a major driver of the market | BioSpace | 9/8/2020

… https://www.transparencymarketresearch.com/valuebased-health-care-services-market.html Value-based health care helps to reduce overall health care spending for society. Commonly used value-based health care models are pay for performance, accountable care organization, bundled payments , and patient-centered medical home. In pay for performance model, providers are paid by payers for meeting pre-measured performance thresholds. It is usually implemented by Medicare and private insurers. Accountable care organizations (ACOs …

3 Top Outpatient and Home Healthcare Stocks to Watch Out For - September 2, 2020 - Zacks.com | 9/2/2020

… total population, prefer outpatient clinic visits. Participating in Alternative Payment Models : It only seems reasonable for outpatient clinics to shift from fee-for-service (FFS) to alternative payment models (APM) with shared savings, risk, bundled payments or population-based payments. With value-based models of care steadily emerging as the future of healthcare, this shift is an ongoing parallel trend. FFS will be crucial to care organizations as a benchmark …

3 Top Outpatient and Home Healthcare Stocks to Watch Out For - September 2, 2020 - Zacks.com | 9/2/2020

… total population, prefer outpatient clinic visits. Participating in Alternative Payment Models : It only seems reasonable for outpatient clinics to shift from fee-for-service (FFS) to alternative payment models (APM) with shared savings, risk, bundled payments or population-based payments. With value-based models of care steadily emerging as the future of healthcare, this shift is an ongoing parallel trend. FFS will be crucial to care organizations as a benchmark …

Simplify Healthcare recognized in Gartner’s Hype Cycle for U.S. Healthcare Payers, 2020 Report | Business Wire | 8/26/2020

… complement current claims-based fee-for-value payments. AP2™ is a modular end-to-end solution that lets you house all your non-bundled fee-for-value payment programs in a single solution, manage bundled payments with agile analytics capability, and generate payments with just a few clicks. It is suitable for all lines of business, including commercial and government programs. Simplify Healthcare continues its fast-paced innovation to deliver …

Veteran’s Appendectomy Launches Excruciating Months-Long Battle Over Bill | Kaiser Health News | 8/25/2020

Veteran’s Appendectomy Launches Excruciating Months-Long Battle Over Bill By Elizabeth Lawrence August 25, 2020 h1 Veteran’s Appendectomy Launches Excruciating Months-Long Battle Over Bill /h1 span class=”byline” Elizabeth Lawrence /span iframe src=”https://www.npr.org/player/embed/904517805/905755524” width=”100%” height=”290” frameborder=”0” scrolling=”no” title=”NPR embedded audio player” /iframe p In late August 2019, Shannon Harness awoke to serious pain in the lower right side of …

Veteran’s Appendectomy Launches Excruciating, Months-Long Battle Over Bill | 8/25/2020

In late August 2019, Shannon Harness awoke to serious pain in the lower right side of his abdomen — a telltale sign of appendicitis . Harness booked it to the emergency room of the only hospital in the county: Heart of the Rockies Regional Medical Center in Salida, Colo. After a CT scan, doctors told Harness he had acute appendicitis and required immediate surgery. A surgeon performed an appendectomy that night and …

Spillover Effects of the Comprehensive Care for Joint Replacement Program Among Non‐Medicare Patients | 8/20/2020

… University of Pennsylvania, Philadelphia, PA, United States; 4 Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA, United States Research Objective Through the Comprehensive Care for Joint Replacement (CJR) Model, mandatory bundled payments for lower extremity joint replacement (LEJR) have produced 3‐4% episode cost savings with stable quality. Though CJR targets Medicare fee‐for‐service patients, it may prompt broad care delivery changes that “spill over” to …

Milliman acquires Torch Insight, expanding industry’s leading portfolio of SaaS health market intelligence solutions | PR Newswire | 8/18/2020

… and partner relationships.” Leavitt Partners Founder and Chairman, and former Secretary of the U.S. Department of Health and Human Services, Mike Leavitt , remarked, “Combining Torch Insight’s comprehensive data on the unique attributes of ACOs, bundled payments , and healthcare stakeholder relationships with MedInsight’s analytic suite, creates the most thorough market intelligence asset available.” For more information, go to milliman.com/en/products/milliman-torch-insight About Milliman Milliman is among the world’s …

Archway Health Announces Accurately Predicted Performance of Provider Partners in BCPI Advanced Performance Period 2 | Malvern Daily Record | 8/12/2020

In June, the Centers for Medicare and Medicaid Services released the Bundled Payments for Care Improvement (BPCI) Advanced reconciliation statement for Performance Period 2 (PP2), covering episodes of care initiated between early April and late September 2019. Today, Archway Health , a full-service, tech-enabled partner to healthcare organizations in risk-based payment programs, announced that the company’s performance projections were within 1% of CMS’ reconciliation statements and resulted in …

News in brief | 8/11/2020

… to deliver medical services to businesses, employees and their dependents. The Arkansas Health Network describes itself as a physician-driven, clinically integrated network that says it uses “new payment models involving shared savings programs, bundled payments and other initiatives focused on quality and value.” The network has more than 2,200 providers, 16 hospitals and 26 skilled nursing facilities. Little Rock Mayor Frank Scott Jr. and Bryan Day, the port executive …

CMS continues shift to value over volume in 2016 IPPS final rule - www.hcpro.com | 8/9/2020

… 1% reduction in MS-DRG payments for all traditional Medicare discharges in FY 2016 due to Hospital-Acquired Condition Reduction Program (HACRP) performance. CMS also addressed provider comments on its plan to expand the Bundled Payments for Care Improvement (BRCI) Initiative. The BPCI Initiative is composed of four related payment models that link payments for multiple services received by Medicare beneficiaries during an episode of care into a bundled payment …

15 Covid-19 forecasts healthcare leaders must get right - MedCity News | 8/7/2020

… the next generations of value-based care contracts. These transitions and decisions include value-based care contracts with private insurers and other programs such as the Oncology Care Model, Comprehensive Care for Joint Replacement, Bundled Payments for Care Improvement – Advanced, Comprehensive ESRD Care Model, and Kidney Care Choices Model. Healthcare leaders need to forecast the results and futures of individual Value-Based Care contracts as well as Value-Based Care …

Trump orders HHS to make telehealth expansion permanent | Modern Healthcare | 8/3/2020

… hours each year. They will likely go into effect January 1, 2021. The agency also wants to boost payments for maternity care bundles, emergency department visits, end-stage renal disease capitated payments and other bundled payments . CMS is proposing several expansions to providers’ scopes of practice too. For instance, the agency wants to allow nurse practitioners, physicians assistants and other non-physician clinicians to supervise diagnostic testing if state laws …

Target Price Adjustment for Hip Fractures Is Not Sufficient In the Bundled Payments for Care Improvement Initiative | 7/31/2020

Under the Bundled Payments for Care Improvement (BPCI) initiative, The Centers for Medicare and Medicaid Services (CMS) adjusts the target price for total hip arthroplasty (THA) based upon the historical proportion of fracture cases. Concerns exist that hospitals that care for hip fracture patients may be penalized in BPCI. The purpose of this study is to compare the episode-of-care costs of hip fracture patients to elective THA patients …

Catalyst for Payment Reform’s Bundled Payment Scorecard for Signify Health Now Available | PR Newswire | 7/29/2020

… and help get people back to health and to their homes as quickly and safely as possible. To request Signify Health’s CPR Summary Scorecard, e-mail [email protected] . Those interested in learning more about bundled payments may register for CPR’s virtual summit here . Registration is free of charge to employer-purchasers, health care purchaser coalitions and accredited media. About Signify Health Signify Health is a leading provider of technology-enabled …

Home Health Heavyweight Encompass Sees Potential to Replace Skilled Nursing with IRFs Post-COVID | 7/29/2020

… report logged more than 15,100 skilled nursing facilities nationwide. Tarr was specifically responding to an analyst question about the outlook for alternative payment models such as the Comprehensive Care for Joint Replacement (CJR) and Bundled Payments for Care Improvement (BPCI) initiatives, which generally seek to lower episodic costs for both acute and subsequent post-acute care. Historically, skilled nursing operators have been wary of such models, as they encourage shorter …

Are We At The Bottom? BPCI Programs Now Disincentivize Providers Who Maintain Quality Despite Caring for Increasingly Complex Patients | 7/25/2020

The Bundled Payments for Care Improvement (BPCI) initiative has been successful at reducing Medicare costs after total joint arthroplasty (TJA). Target pricing is based on each institution’s historical performance and is periodically reset. The purpose of this study was to examine the performance of our BPCI program accounting for patient complexity, quality, and resource utilization. Methods We reviewed a consecutive series of 9195 Medicare patients undergoing primary TJA from 2015 …

Effect of Bundled Payments as a Care Improvement Initiative on Hospital Care of Total Joint and Sepsis: A Perspective on Organizational Effectiveness | 7/24/2020

This study investigates the potential impact of the Bundled Payments for Care Improvement (BPCI) initiative from Center for Medicare and Medicaid Services on hospital performance and behavior related to effectiveness and efficiency. The BPCI is under the Affordable Care Act and provides hospitals with a fixed amount of reimbursement for a total episode of care. Building on the agency theory, I argue that the BPCI initiative has the potential to …

Catholic Health, local surgeons partner for orthopedic clinical management program | Becker’s ASC Review | 7/23/2020

… Orthopedic Management Group is the second such arrangement in the area. In 2019, Allied Joint Reconstruction Management was formed focusing on several similar initiatives. 4. While Allied Joint specifically focuses on joint reconstruction and bundled payments , this group is focused on improving patient outcomes and the patient experience …

UnitedHealthcare gets lowest grades in Leapfrog poll, average plan gets C+ | Healthcare Dive | 7/22/2020

… has also been shifting away from fee-for-service payment models that incentivize providers to deliver greater volume, not better quality. Many large, self-funded companies have pushed for alternate payment models, such as bundled payments , centers of excellence and direct contracting with providers, which removes the payer from the equation altogether. About a fourth of employers told Leapfrog they use an APM, but most aren’t satisfied with what their …

CMS Releases Initial Report on Risk-Based Bundled Payment Model | RevCycle Intelligence | 7/1/2020

Value-Based Care News CMS Releases Initial Report on Risk-Based Bundled Payment Model Early data from the Bundled Payments for Care Improvement Advanced model show promise for savings, but new research says episode design plays a bigger part in whether bundled payment models truly work. July 01, 2020 - Hospitals and physician group practices (PGPs) participating in the first two cohorts of the Bundled Payments for Care Improvement (BPCI) Advanced …

The future of private practice and payers in spine: 3 key thoughts | 6/24/2020

Three orthopedic and spine surgeons participated in a panel titled “The Future of Practice, Bundled Payments , Out-of-Network, Venture Capital, Hospital Partnerships and More” on June 18 as part of the Becker’s Spine, Orthopedic and Pain Management-Driven ASC + the Future of Spine virtual event. Click here to view the full interview on-demand as well as access several other fireside chats, panels and workshops during the event. The …

CMS releases inaugural-year evaluation of BPCI Advanced | 6/22/2020

CMS releases inaugural-year evaluation of BPCI Advanced Jun 22, 2020 - 02:33 PM The Centers for Medicare & Medicaid Services last week released the first annual report evaluating the Bundled Payments for Care Improvement Advanced Model. The alternative payment model, launched in October 2018 by the Center for Medicare and Medicaid Innovation, tests whether linking Medicare provider payments with episodes of care can reduce Medicare expenditures while improving quality. The report …

COVID-19

15 Covid-19 forecasts healthcare leaders must get right - MedCity News | 8/7/2020

… novel coronavirus began infecting these budgeting forecasting models. The CDC announced the first community spread and fifteen known cases of Covid-19 in the United States. On March 11, the U.S. had 1,100 known Covid … as the Oncology Care Model, Comprehensive Care for Joint Replacement, Bundled Payments for Care Improvement – Advanced, Comprehensive ESRD Care Model, and Kidney Care Choices Model. Healthcare leaders need to forecast the results and futures of …

American Medical Association

Trump orders HHS to make telehealth expansion permanent | Modern Healthcare | 8/3/2020

American Medical Association and other groups. According to CMS, the proposed changes will save clinicians 2.3 million hours each year. They will likely go into effect January 1, 2021. The agency also wants to boost payments for maternity care bundles, emergency department visits, end-stage renal disease capitated payments and other bundled payments. CMS is proposing several expansions to providers’ scopes of practice too. For instance, the agency wants to …

American Hospital Association

UnitedHealthcare gets lowest grades in Leapfrog poll, average plan gets C+ | Healthcare Dive | 7/22/2020

… American Hospital Association. The healthcare industry has also been shifting away from fee-for-service payment models that incentivize providers to deliver greater volume, not better quality. Many large, self-funded companies have pushed for alternate payment models, such as bundled payments, centers of excellence and direct contracting with providers, which removes the payer from the equation altogether. About a fourth of employers told Leapfrog they use an APM, but …

Medicare

CMS Releases Initial Report on Risk-Based Bundled Payment Model | RevCycle Intelligence | 7/1/2020

Value-Based Care News CMS Releases Initial Report on Risk-Based Bundled Payment Model Early data from the Bundled Payments for Care Improvement Advanced model show promise for savings, but new research says episode design … the report stressed. BPCI Advanced is a new iteration of Medicare’s bundled payment model, Bundled Payments for Care Improvement. This version of the model was designed to encourage participation from providers with a range of …

BPCI

CMS Releases Initial Report on Risk-Based Bundled Payment Model | RevCycle Intelligence | 7/1/2020

Value-Based Care News CMS Releases Initial Report on Risk-Based Bundled Payment Model Early data from the Bundled Payments for Care Improvement Advanced model show promise for savings, but new research says episode design plays a bigger part in whether bundled payment models truly work. July 01, 2020 - Hospitals and physician group practices (PGPs) participating in the first two cohorts of the Bundled Payments for Care Improvement (BPCI) Advanced …

ACO

CMS Releases Initial Report on Risk-Based Bundled Payment Model | RevCycle Intelligence | 7/1/2020

Value-Based Care News CMS Releases Initial Report on Risk-Based Bundled Payment Model Early data from the Bundled Payments for Care Improvement Advanced model show promise for savings, but new research says episode design … Commission recently identified a similar practice in accountable care organizations (ACOs). The Commission advised policymakers to prevent such gaming of the model to generate greater savings from ACOs. But that is not to say bundled …

Medicaid

Vizient Offers Recommendations to CMS on Proposed Rule for Comprehensive Care for Joint Replacement Model | Business Wire | 4/24/2020

IRVING, Texas–(BUSINESS WIRE)–Apr 24, 2020– Vizient, Inc . today submitted recommendations to the Centers for Medicare & Medicaid Services (CMS) for the proposed rule, “Comprehensive Care for Joint Replacement Model Three Year Extension and Modifications … to align several components of the CJR model with the Bundled Payments for Care Improvement Advanced (BPCIA) model as it can both help reduce administrative burden and enhance provider understanding of each model,” said Shoshana …

Centers for Medicare and Medicaid Services

Online Case Management Boot Camp: Strategies for Success in the Acute Care Setting and Beyond (May 18, 2020) | Globe Newswire | 4/21/2020

… bundled payments, transitions in care, or accountable care organizations, case management is at the center of it all.Because things are changing so rapidly, it can be a challenge to stay current and knowledgeable in the issues that most greatly impact your role as an acute care case manager or social worker. Reimbursement has changed dramatically as has utilization management, transitional planning and compliance. The Centers for Medicare and Medicaid Services

Behavioral Health

Government’s Decision To Cut Cost-Sharing Reduction Payments Paid Off For Rural Consumers | Kaiser Health News | 12/4/2019

… enrollees. The Trump administration has solicited feedback on potentially banning silver-loading in 2021. In other insurance and costs news: bundled payments, penalties, health care sharing ministries and more. Modern Healthcare: Subsidized Rural Health Premiums … month to open its 500th pharmacy that’s focused on the behavioral health care needs of certain clinic patients. The pharmacy is part of a business that UnitedHealth Group acquired last year and exemplifies how the …

Readmissions

Bundled payments get a boost in two states with employee programs | Modern Healthcare | 12/3/2019

… outpatient procedure, including all facility and professional expenses. Each bundle also comes with a 30-day warranty that covers all readmissions or complications related to the surgical episode. Hospitals and physician groups participating in the … us. It greases the wheels for more providers to adopt bundled payments

Ambulatory Surgery Centers

ValueHealth Announces Elizabeth Jaekle as Mid-Atlantic Regional President | PR Newswire | 11/22/2019

LEAWOOD, Kan. , Nov. 22, ValueHealth, LLC a privately held, nationally trusted digital and surgical healthcare partner, is pleased to announce the hiring of Elizabeth Jaekle as Mid-Atlantic Regional President. ValueHealth’s technology-enabled market-based platform assists payors and providers in delivering appropriate alternatives to high-cost, fee-for-service surgical care. In her role as Regional President, Ms. Jaekle will deliver on the next phase of the company’s regional …

Medicare Advantage

Value-Based Care Models Gain Steam, Cut 20% of MA Spending | HealthPayer Intelligence | 11/21/2019

Value-Based Care Models Gain Steam, Cut 20% of MA Spending Humana’s lowered spending and raised savings through bundled payments, payer-provider partnerships, and outcomes-oriented strategies. Evidence is mounting to confirm that are more cost-effective than fee-for-service, according to Humana’s fifth Value-Based Care Report, which said bundled payments and value-based payer-provider partnerships are key to this process. The major payer’s Medicare Advantage plan …

ACA

Acadia Professional Taps Judge Paul W. Armstrong J.S.C. (Ret.) to Chair New Advisory Board, Adds Lili Brillstein, Bill Burns, and Brian Kern | PR Newswire | 11/19/2019

MORRISTOWN, N.J. , Nov. 19, Acadia Professional, LLC (Acadia) announces the establishment of a Value Based Care Risk Advisory Board - the first of its kind in the United States. Advisory Board Members will counsel Acadia on … Jersey . Brillstein is a passionate advocate of Episodes of Care/Bundled Payments as a strategy to successfully migrate from fee for service to quality- & value-based models that rewards providers for excellent outcomes and patient …

Patient Engagement

Analytics, precision medicine key to value-based care, but health systems struggle with funding: KLAS survey | FierceHealthcare | 11/18/2019

Limited funding and lack of reimbursement from payers are the top hurdles to patient engagement technologies, analytics and precision medicine, according to a survey of chief information officers. Healthcare providers plan to ramp up investments … it, so we look at it as if there are bundled payments. That works well, but obviously, adoption rises when something is covered by insurance because people can consider convenience and cost.” Despite that, health …

Value-Based Reimbursement

Post-acute providers often lack budget to implement critical health IT | Healthcare IT News | 11/15/2019

value-based reimbursement reforms affect both the acute-care and long-term and post-acute care markets, patient data-sharing is essential for reducing readmission rates and advancing outcomes,” he said. Brown pointed out the lack of data and analysis is excluding most long-term and post-acute providers from value-based care programming. Meanwhile, the design of some of those initiatives, such as bundled payments and shared risk, could …

Home Health

Post-acute providers often lack budget to implement critical health IT | Healthcare IT News | 11/15/2019

… term and post-acute providers from value-based care programming. Meanwhile, the design of some of those initiatives, such as bundled payments and shared risk, could feasibly lead to the provision of fewer post-acute … inclusion by focusing on the role of skilled nursing, rehabilitation, home health and sub-acute providers. Nathan Eddy is a healthcare and technology freelancer based in Berlin. Email the writer: Healthcare IT News is a …

Digital Health

Investors are shrugging off fear of Medicare for All – for now | CNBC | 11/10/2019

… of medical care. She says she would expand the “value-based reforms enabled by the Affordable Care Act,” such as bundled payments for in-patient and post-operative care, and encourage better coordination of treatment … self-insured employer market has been more open to new digital health models. Telemedicine has been a prime example. Large employers and private insurers have embraced the technology for years, and for 2020 many are …

CMS Innovation Center

Oncology Care Model: Progress along the learning curve | 11/8/2019

bundled payments of this type. I use the term “potential” deliberately, because although there are some early signs of quality improvement, it is too early to claim victory for the OCM as a scalable model of value-based care. OCM basics As a reminder, the OCM is piloted by the CMS Innovation Center to improve the effectiveness and efficiency of cancer care. The 5-year program started in July 2016 …

Pain Management

Dr. James T. Caillouette: Bundled payments + the joint replacement ‘revolution’ | Becker’s ASC Review | 11/5/2019

… same-day joint replacement is increasingly common: “Innovations in the surgical approach to hip and knee replacements are part of the drivers behind the trend. Couple this with newer and improved anesthesia and pain management techniques as well as accelerated and customized physical therapy regimens and the result is a revolution in joint replacement surgery.” Click here to read the full feature by Orange County Breeze. More articles on orthopedics …

Population Health

Value-Based Care Gets a Chance To Be Present at the Creation | Managed Care Magazine | 11/4/2019

… for Healthcare Value. But until he arrived in Austin, he had never run a medical school or a health system. Population health and value-based care “are central and clearly integrated” into the curriculum, says … reductions for certain conditions—but only two payers are making bundled payments to Dell Med for its integrated practice unit care. Most continue to pay fee for service for knee replacement surgery and have no …

Patient Satisfaction

CMS to Pay $1.9B in Value-Based Purchasing Incentive Payments | RevCycle Intelligence | 10/30/2019

… similar programs to rethink their value-based purchasing strategy. “So far, there’s no evidence the program has improved quality or patient satisfaction,” Jose F. Figueroa, MD, MPH, co-author of both studies and an instructor … and other providers to take on more complex models, like bundled payments and accountable care organization (ACO) contracts, which have the potential for downside financial risk. Tagged …

ACOs

CMS thinks artificial intelligence could help cut Medicare fraud | Modern Healthcare | 10/22/2019

… bundled payments. Those models are based on original Medicare’s fee-for-service payment structure. Newer payment models like Next Generation ACOs take things a step further because they’re not tied to acute medical events and pay for long-term health outcomes. The CMS is worried that value-based payments could pose new problems like underutilization and improper risk adjustment for covered patients. New technology could bolster program integrity, especially when …

Healthcare Payment Reform

Archway Health Offers First Patient Case Mix Analytics Tool for BPCI Advanced Participants | Business Wire | 10/9/2019

… Analytics that allows providers to understand how the case mix of their patient population will impact their performance in the Bundled Payments for Care Improvement (BPCI) Advanced program. Believed to be the first of its … founded in 2014 and built on a deep foundation of healthcare payment reform expertise, works with providers and employers to design and execute care and risk management initiatives that improve care and reduce costs. Archway …

Patient Safety

RWJBarnabas Health CFO focuses on strategy in industry under ‘economic siege’ | Becker’s Hospital Review | 10/8/2019

… our overall system strategy, which includes launching a journey towards becoming a high reliability organization, an important foundation to ensuring patient safety, and focusing on quality. Much of our activity over the few years since … and leveraging what we’ve learned from Medicare programs such as Bundled Payments for Care Improvement Advanced and others to develop deeper relationships with commercial insurance plans and the Medicare managed care plans in New Jersey …

Hospital Readmissions

CMS overhauls SNF payment model | Modern Healthcare | 9/14/2019

… In its place will be the Patient Driven Payment Model based on acuity and other data-driven characteristics akin to bundled payments. The former reimbursement model encouraged potentially unnecessary therapy services, the CMS said, adding … stay decreases, but will have to balance that with preventing hospital readmissions. These providers must prepare to take on more complex patients, such as those relying on ventilators, mostly due to the aging population, Stoll …

Vizient

Vizient Offers Recommendations to CMS on Proposed Rule for Comprehensive Care for Joint Replacement Model | Business Wire | 4/24/2020

IRVING, Texas–(BUSINESS WIRE)–Apr 24, 2020– Vizient, Inc . today submitted recommendations to the Centers for Medicare & Medicaid Services (CMS) for the proposed rule, “Comprehensive Care for Joint Replacement Model Three Year Extension and Modifications … to align several components of the CJR model with the Bundled Payments for Care Improvement Advanced (BPCIA) model as it can both help reduce administrative burden and enhance provider understanding of each model,” said Shoshana …

Carrum Health

Carrum Health Presses Pause on All Elective Procedures Effective Immediately | PR Newswire | 3/16/2020

SAN FRANCISCO Carrum Health , the first digital health company connecting employers and employees directly with Centers of Excellence (COEs) providers through its bundled payment platform, today announced it is standing with the U.S. Surgeon General … to the patient. Through Carrum, employers can take advantage of bundled payments for several of the highest-cost medical spend areas, including musculoskeletal, bariatrics, neurosurgery and cardiovascular specialties. Carrum negotiates these bundled payments with COEs …

UnitedHealth

Government’s Decision To Cut Cost-Sharing Reduction Payments Paid Off For Rural Consumers | Kaiser Health News | 12/4/2019

… enrollees. The Trump administration has solicited feedback on potentially banning silver-loading in 2021. In other insurance and costs news: bundled payments, penalties, health care sharing ministries and more. Modern Healthcare: Subsidized Rural Health Premiums … a health care sharing ministry. (Bookman, 12/2) The Star Tribune: UnitedHealth Group Touts Optum Effect On Its Corporate Growth UnitedHealth Group plans this month to open its 500th pharmacy that’s focused on the behavioral health …

UnitedHealth Group

Government’s Decision To Cut Cost-Sharing Reduction Payments Paid Off For Rural Consumers | Kaiser Health News | 12/4/2019

… enrollees. The Trump administration has solicited feedback on potentially banning silver-loading in 2021. In other insurance and costs news: bundled payments, penalties, health care sharing ministries and more. Modern Healthcare: Subsidized Rural Health Premiums … a health care sharing ministry. (Bookman, 12/2) The Star Tribune: UnitedHealth Group Touts Optum Effect On Its Corporate Growth UnitedHealth Group plans this month to open its 500th pharmacy that’s focused on the behavioral health …

Walmart Health

Bundled payments get a boost in two states with employee programs | Modern Healthcare | 12/3/2019

… slow to embrace these fixed-payment models despite Medicare’s generally favorable experience with bundles. In contrast, some large employers like Walmart , Boeing and United Airlines as well as employer coalitions like the Pacific Business Group … us. It greases the wheels for more providers to adopt bundled payments

NaviHealth

Providers Mull Options for BPCI Advanced | Managed Care Magazine | 12/2/2019

… Advanced December 2, 2019 Michael D. Dalzell This month, hospitals and physicians in the second wave of applicants to CMS’s Bundled Payments for Care Improvement Advanced (BPCI-A) model are deciding whether to take the … says Gina Bruno, vice president of value-based care at naviHealth, a company headquartered in Nashville that helps provider organizations manage their participation in BPCI-A. Top 10 episodes by participation, BPCI-A Years 1 …

Persivia

Persivia™ Secures $15 Million Growth Financing from Petrichor Healthcare Capital Management | PRWeb | 10/10/2019

Persivia™ Secures $15 Million Growth Financing from Petrichor Healthcare Capital Management Share Article Persivia Inc., the AI-driven value-based care solution provider, has announced today that it has closed a $15 million financing from … has added over 50 hospitals participating in the value-based Bundled Payments program and has also partnered with a large hospital group for Chronic Care Management deployment. “We have a leading product for the healthcare …

Archway Health

Archway Health Offers First Patient Case Mix Analytics Tool for BPCI Advanced Participants | Business Wire | 10/9/2019

BOSTON- Archway Health , a full-service, tech-enabled partner to healthcare organizations in risk-based payment programs, today announced the Patient Case Mix Adjustment (PCMA) Tool in Archway Analytics that allows providers to understand how the case mix of their patient population will impact their performance in the Bundled Payments for Care Improvement (BPCI) Advanced program. Believed to be the first of its kind, Archway’s PCMA function complements the existing …

Remedy Partners

Signify Health, Remedy Partners to Bring In-Home Care into Bundled Payments with Planned Merger | Home Health Care News | 8/22/2019

Signify Health — a technology-enabled health care services provider — and Remedy Partners — a software company that aligns providers in “episode-based” bundled payment models — have signed a definitive agreement to merge. Financial terms of the … in episodes and help the government meet its goals in Bundled Payments for Care Improvement (BPCI),” Goldstein said. “And through our longitudinal complex care management services and solutions to address social determinants, help our other …

Avant-garde Health

Hollywood Presbyterian uses bundle management platform to succeed in value-based care | Healthcare IT News | 6/20/2019

… Medical Center was accepted into the first cohort of hospitals to participate in the Centers for Medicare and Medicaid Services’ “Bundled Payments for Care Improvement Advanced” model THE PROBLEM In this program, CMS sets a … the provider organization decided it needed to partner with vendor Avant-garde Health to help it understand where these costs were being incurred so it could effectively manage them. The technology Hollywood Presbyterian uses is …

National Medical Billing Services

High-deductible patients, outpatient bundles + more — 3 Qs with CEO Theresa Hush | Becker’s ASC Review | 6/20/2019

Sponsored by National Medical Billing Services [email protected] (636) 273-6711 High-deductible patients, outpatient bundles + more — 3 Qs with CEO Theresa Hush Written by Angie Stewart June 19, Outpatient surgery providers have been slow to adopt bundled payments, which offer an opportunity for ASCs to prove themselves as a viable care option, according to Roji Health Intelligence CEO Theresa Hush . Note: Responses were edited for length and style. Question: What …

Cerner

Cerner and naviHealth Extend Partnership, Boost EHR Service | Zacks | 4/15/2019

Cerner and naviHealth Extend Partnership, Boost EHR Service Zacks Equity Research You follow Analyst Blog - edit You follow Zacks Equity Research - edit What would you like to follow? Zacks Equity Research Cancel Read More Hide … alliance is aimed at developing a new offering for Medicare’s Bundled Payments for Care Improvement Advanced program (BPCI Advanced).The new service will lend healthcare providers an opportunity to participate actively in the BPCI Advanced …

Clarify Health Solutions

Clarify Health Welcomes Dr. Mark Froimson as Strategic Advisor to Drive Care Optimization and Success in Risk-Based Payment Models | PR Newswire | 11/29/2017

… with technology to thrive in value-based care News provided by 08:09 ET Share this article SAN FRANCISCO , Nov. 29, Clarify Health Solutions, Inc ., a pioneer in predictive care optimization, announced today that Mark Froimson … in risk-based payment models. These include participants in CMS’ Bundled Payments for Care Improvement (BPCI) program and the soon-to-be announced BPCI Advanced program, in which many providers have chosen to focus on …

Harvard Medical School

Value-Based Care Gets a Chance To Be Present at the Creation | Managed Care Magazine | 11/4/2019

… and moved through Boston, Denver, and other cities as his father’s academic career progressed. He graduated from Amherst College and Harvard Medical School and received a PhD in epidemiology from the University of California–Berkeley … reductions for certain conditions—but only two payers are making bundled payments to Dell Med for its integrated practice unit care. Most continue to pay fee for service for knee replacement surgery and have no …

CMS to Pay $1.9B in Value-Based Purchasing Incentive Payments | RevCycle Intelligence | 10/30/2019

… quality or patient satisfaction,” Jose F. Figueroa, MD, MPH, co-author of both studies and an instructor of medicine at Harvard Medical School, recently said in a New York Times article penned by Austin Frakt … and other providers to take on more complex models, like bundled payments and accountable care organization (ACO) contracts, which have the potential for downside financial risk. Tagged …

Kaiser Permanente

Healthcare Services: Global Market Opportunities & Strategies to 2022 - ResearchAndMarkets.com | Business & Finance | manchestertimes.com | Business Wire | 5/7/2019

… made up 4.9% of the total market in 2018. Major players in the market include the UK National Health Service, Kaiser Permanente, Fresenius Medical Care AG & Co. KGaA, Community Health Systems, Inc., DaVita Inc., and … Healthcare services trend-based strategies include increasing the adoption of bundled payments, using digital tools and adopting shared medical appointments by companies. Players adopted strategies in the healthcare services industry include acquiring companies in similar …

Better quality, lower costs when providers and payers share risk | Healthcare Dive | 4/15/2019

… bundled payments. Proponents of value-based care say that it rewards providers for offering high quality with lower costs. However, providers remain leery of taking on more risk. The report analyzed and compared data from seven payers of providers that take on no risk, only professional risk and full risk. The members comprised about 55 percent of the statewide commercial enrollment. The researchers excluded Kaiser Permanente since that integrated system’s …

Maricopa Integrated Health System

WellCare Unit Inks Deal to Serve Medicaid Liver Patients - April 16, 2019 - Zacks.com | 4/16/2019

… WellCare Health Plans, Inc .’s ( WCG - Free Report ) unit Care1st Health Plan Arizona, has signed a value-based deal with Maricopa Integrated Health System (MIHS) on Oct 1, 2018 to launch the Hepatitis C Center … when a Medicaid plan in the United States has provided bundled payments as part of a value-based agreement for treating hepatitis C. Notably, around 90,000 people in Arizona are suffering Hepatitis C, which makes …

WellCare Unit Inks Deal to Serve Medicaid Liver Patients | Zacks | 4/16/2019

… WellCare Health Plans, Inc .’s ( WCG - Free Report ) unit Care1st Health Plan Arizona, has signed a value-based deal with Maricopa Integrated Health System (MIHS) on Oct 1, 2018 to launch the Hepatitis C Center … when a Medicaid plan in the United States has provided bundled payments as part of a value-based agreement for treating hepatitis C.Notably, around 90,000 people in Arizona are suffering Hepatitis C, which makes it …

The Centers

Cerner and naviHealth Extend Partnership, Boost EHR Service | Zacks | 4/15/2019

… Report ) recently extended its existing relationship with naviHealth. This latest alliance is aimed at developing a new offering for Medicare’s Bundled Payments for Care Improvement Advanced program (BPCI Advanced).The new service will lend healthcare … payment model — Bundled Payments for Care Improvement Advanced — announced by The Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation will test a new iteration of the bundled payments for 32 Clinical …

Cerner and naviHealth Extend Partnership, Boost EHR Service - April 15, 2019 - Zacks.com | 4/15/2019

… Report ) recently extended its existing relationship with naviHealth. This latest alliance is aimed at developing a new offering for Medicare’s Bundled Payments for Care Improvement Advanced program (BPCI Advanced). The new service will lend healthcare … payment model — Bundled Payments for Care Improvement Advanced — announced by The Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation will test a new iteration of the bundled payments for 32 Clinical …

Trinity Health

Clarify Health Welcomes Dr. Mark Froimson as Strategic Advisor to Drive Care Optimization and Success in Risk-Based Payment Models | PR Newswire | 11/29/2017

… cohort of strategic advisors to the San Francisco -based startup, served as chief clinical officer and executive vice president of Trinity Health, the Michigan -based hospital system, from November 2014 through May 2017 . During his … in risk-based payment models. These include participants in CMS’ Bundled Payments for Care Improvement (BPCI) program and the soon-to-be announced BPCI Advanced program, in which many providers have chosen to focus on …

Clarify Health Welcomes Dr. Mark Froimson as Strategic Advisor to Drive Care Optimization and | PR Newswire | 11/29/2017

… cohort of strategic advisors to the San Francisco -based startup, served as chief clinical officer and executive vice president of Trinity Health, the Michigan -based hospital system, from November 2014 through May 2017 . During his … in risk-based payment models. These include participants in CMS’ Bundled Payments for Care Improvement (BPCI) program and the soon-to-be announced BPCI Advanced program, in which many providers have chosen to focus on …

Department of Veterans Affairs

Remedy Partners Welcomes Former Undersecretary for Health, Department of Veterans Affairs as Executive Vice President of Commercial Business Lines | Business Wire | 11/1/2017

… proven success in clinical and hospital practice administration, managed care and healthcare policy. As Under Secretary for Health at the Department of Veterans Affairs, she helped oversee a healthcare system of more than 9 million … platforms that enable innovative new insurance offering that rely on bundled payments for patient episodes-of-care. These new benefit plans offer health plans and self-insured employers the ability to achieve the price points …

CORRECTING and REPLACING Remedy Partners Welcomes Former Acting Under Secretary for Health, Department of Veterans Affairs as Executive Vice President of Commercial Business Lines | CNBC | 11/1/2017

… following corrected version due to multiple revisions. The corrected release reads: REMEDY PARTNERS WELCOMES FORMER ACTING UNDER SECRETARY FOR HEALTH, DEPARTMENT OF VETERANS AFFAIRS AS EXECUTIVE VICE PRESIDENT OF COMMERCIAL BUSINESS LINES Dr. Poonam Alaigh … platforms that enable innovative new insurance offerings that rely on bundled payments for patient episodes-of-care. These new benefit plans offer health plans and self-insured employers the ability to achieve the price points …

UnitedHealthcare

UnitedHealthcare gets lowest grades in Leapfrog poll, average plan gets C+ | Healthcare Dive | 7/22/2020

… healthcare. Blue Cross Blue Shield plans got the highest GPA: 2.59. Cigna got a 2.5, Aetna got a 2.47 and UnitedHealthcare got a 2.29. Dive Insight: A little more than half (58%) of employers told … funded companies have pushed for alternate payment models, such as bundled payments, centers of excellence and direct contracting with providers, which removes the payer from the equation altogether. About a fourth of employers told Leapfrog …

Government’s Decision To Cut Cost-Sharing Reduction Payments Paid Off For Rural Consumers | Kaiser Health News | 12/4/2019

… enrollees. The Trump administration has solicited feedback on potentially banning silver-loading in 2021. In other insurance and costs news: bundled payments, penalties, health care sharing ministries and more. Modern Healthcare: Subsidized Rural Health Premiums … how the Minnetonka-based health care giant has diversified beyond UnitedHealthcare, the core health insurance business that remains the largest carrier in the county. (Snowbeck, 12/3) This is part of the KHN Morning Briefing, a …

Humana

Value-Based Care Models Gain Steam, Cut 20% of MA Spending | HealthPayer Intelligence | 11/21/2019

Value-Based Care Models Gain Steam, Cut 20% of MA Spending Humana’s lowered spending and raised savings through bundled payments, payer-provider partnerships, and outcomes-oriented strategies. Evidence is mounting to confirm that are more cost-effective than fee-for-service, according to Humana’s fifth Value-Based Care Report, which said bundled payments and value-based payer-provider partnerships are key to this process. The major payer’s Medicare Advantage plan …

Waste accounts for one-quarter of healthcare spending | Modern Healthcare | 10/7/2019

… years,” said Dr. William Shrank, an author of the study and chief medical and corporate affairs officer for health insurer Humana. “We thought it was an appropriate time to update that study.” Shrank undertook the … study on healthcare waste , said value-based payment arrangements like bundled payments and accountable care organizations have been shown to generate 1% to 3% in cost savings—a “big gap” from the waste estimates researchers …

Care1st Health Plan

WellCare Unit Inks Deal to Serve Medicaid Liver Patients - April 16, 2019 - Zacks.com | 4/16/2019

WellCare Health Plans, Inc .’s ( WCG - Free Report ) unit Care1st Health Plan Arizona, has signed a value-based deal with Maricopa Integrated Health System (MIHS) on Oct 1, 2018 to launch the Hepatitis C Center … when a Medicaid plan in the United States has provided bundled payments as part of a value-based agreement for treating hepatitis C. Notably, around 90,000 people in Arizona are suffering Hepatitis C, which makes …

WellCare Unit Inks Deal to Serve Medicaid Liver Patients | Zacks | 4/16/2019

… to follow? Zacks Equity Research Cancel Read More Hide Full Article WellCare Health Plans, Inc .’s ( WCG - Free Report ) unit Care1st Health Plan Arizona, has signed a value-based deal with Maricopa Integrated Health System … when a Medicaid plan in the United States has provided bundled payments as part of a value-based agreement for treating hepatitis C.Notably, around 90,000 people in Arizona are suffering Hepatitis C, which makes it …

WellCare Health

WellCare Unit Inks Deal to Serve Medicaid Liver Patients - April 16, 2019 - Zacks.com | 4/16/2019

WellCare Health Plans, Inc .’s ( WCG - Free Report ) unit Care1st Health Plan Arizona, has signed a value-based deal with Maricopa Integrated Health System (MIHS) on Oct 1, 2018 to launch the Hepatitis C Center … when a Medicaid plan in the United States has provided bundled payments as part of a value-based agreement for treating hepatitis C. Notably, around 90,000 people in Arizona are suffering Hepatitis C, which makes …

WellCare Unit Inks Deal to Serve Medicaid Liver Patients | Zacks | 4/16/2019

… follow Zacks Equity Research - edit What would you like to follow? Zacks Equity Research Cancel Read More Hide Full Article WellCare Health Plans, Inc .’s ( WCG - Free Report ) unit Care1st Health Plan Arizona, has signed … when a Medicaid plan in the United States has provided bundled payments as part of a value-based agreement for treating hepatitis C.Notably, around 90,000 people in Arizona are suffering Hepatitis C, which makes it …

Alan Condon

Outpatient joint replacements to ‘skyrocket over next 10 years,’ says Dr. Richard Berger | Beckers Spine Review | 3/16/2020

Outpatient joint replacements to ‘skyrocket over next 10 years,’ says Dr. Richard Berger Written by Alan Condon March 16, 2020 Print Email The Western Society of Engineers recently recognized orthopedic surgeon Richard Berger, MD, with … robotic-assisted surgery in orthopedics and the increasing trend of bundled payments. Note: Responses are lightly edited for style and clarity. Question: Congratulations on the 2020 Washington Award. What does this award mean for you …

Sach Jain

Carrum Health Presses Pause on All Elective Procedures Effective Immediately | PR Newswire | 3/16/2020

… what’s best for public health and to take a stand for what’s right,” said Carrum Health Co-founder and CEO Sach Jain . “Right now, the most important thing we can do is protect the welfare … to the patient. Through Carrum, employers can take advantage of bundled payments for several of the highest-cost medical spend areas, including musculoskeletal, bariatrics, neurosurgery and cardiovascular specialties. Carrum negotiates these bundled payments with COEs …

Brian Kern

Acadia Professional Taps Judge Paul W. Armstrong J.S.C. (Ret.) to Chair New Advisory Board, Adds Lili Brillstein, Bill Burns, and Brian Kern | PR Newswire | 11/19/2019

… Burns , who is a nationally-recognized expert on professional liability insurance and the marketplace as a whole. We’re delighted that Brian Kern , partner at Acadia, will also serve as an integral member of the Advisory … Jersey . Brillstein is a passionate advocate of Episodes of Care/Bundled Payments as a strategy to successfully migrate from fee for service to quality- & value-based models that rewards providers for excellent outcomes and patient …

Bernie Sanders

Investors are shrugging off fear of Medicare for All – for now | CNBC | 11/10/2019

US Senator Elizabeth Warren (C), Democrat from Massachusetts, speaks with US Senator Bernie Sanders (2nd R), Independent from Vermont, as they discusses Medicare for All legislation on Capitol Hill in Washington, DC, on September 13 … based reforms enabled by the Affordable Care Act,” such as bundled payments for in-patient and post-operative care, and encourage better coordination of treatment to try to bring down costs. “On the one hand …

Rachel Popa

CMS covering opioid use disorder treatment in 2020: 3 things to know | Becker’s ASC Review | 11/1/2019

Rachel Popa November 01, 2019 Print Email Opioid use disorder treatment will be covered under CMS’ 2020 physician fee schedule final rule. Three things to know: 1. The rule is scheduled to take effect Jan. 1, 2020, and will cover therapies like methadone, as well as in-person and virtual visits to opioid treatment programs. 2. Medicare will pay opioid treatment programs in bundled payments for weekly episodes of care …

Anne Tumlinson

I-SNP Case Studies Show Promise in Era Where Fee-for-Service Medicare Looks Unsustainable | 10/28/2019

… models. Advertisement “The Medicare program for only so much longer can continue to pay on a fee-for-service basis,” Anne Tumlinson, CEO of consulting firm Anne Tumlinson Innovations, said during the presentation. “It’s really … calls on operators to adapt to new models such as bundled payments were met with resistance. But given the deleterious effects of that model — along with accountable care organizations and Medicare Advantage in general — the …

Mark McClellan

36% of Payments Tied to Alternative Payment Models in 2018 | RevCycle Intelligence | 10/24/2019

… Healthcare payments are moving away from fee-for-service, with 25.1% linked to value and quality and 35.8% tied to bundled payments, shared savings, and other HCP-LAN reported. Source: Thinkstock The healthcare industry is … and private commitment than ever before – including through the LAN,” Mark McClellan, LAN co-chair, said in a press release. Dig Deeper Practices Still Averse to Risk-Based Alternative Payment Models The healthcare industry has …

Seema Verma

Therapists look to CMS for aid as SNFs restructure | Modern Healthcare | 10/4/2019

… model aimed to eliminate that incentive by basing pay on the needs of the patient and care quality, similarly to bundled payments. Skilled-nursing chains have terminated or “transitioned” many of their therapists. Those who … model to one that relies on patient characteristics. CMS Administrator Seema Verma wants to revamp the 340B drug discount program by cutting Medicare Part B reimbursement to hospitals that get deeply discounted drugs from pharmaceutical …

Frank Phillips

Episodes of care and bundled payments, a sustainable approach | Beckers Spine Review | 8/23/2019

… is a portion of a book titled “ Challenges, Risks and Opportunities in Today’s Spine World “ edited by Stephen Hochschuler, MD, Frank Phillips, MD, and Richard Fessler, MD. You can find links to the previous chapters … easily understood, actionable information, or nothing is accomplished. Also remember bundled payments are a learning process…for everyone. The first set of reports may not be in a format that speaks to those who need …

Stephen Hochschuler

Episodes of care and bundled payments, a sustainable approach | Beckers Spine Review | 8/23/2019

This article is a portion of a book titled “ Challenges, Risks and Opportunities in Today’s Spine World “ edited by Stephen Hochschuler, MD, Frank Phillips, MD, and Richard Fessler, MD. You can find links to the … easily understood, actionable information, or nothing is accomplished. Also remember bundled payments are a learning process…for everyone. The first set of reports may not be in a format that speaks to those who need …

Angie Stewart

How Surgical Care Affiliates’ CMO gets physicians on board with bundles + 4 more insights | Becker’s ASC Review | 7/9/2019

As chief medical officer for Deerfield, Ill.-based Surgical Care Affiliates, Daniel Murrey, MD, spearheads many initiatives related to bundled payments and value-based care. Dr. Murrey shared his knowledge with Becker’s ASC Review . Note … care. Interested in participating in future Becker’s Q&As? Email Angie Stewart at More articles on coding, billing and collections …

Laura Dyrda

The future of spine practice and bundled payments: 6 key thoughts | Beckers Spine Review | 6/19/2019

The future of spine practice and bundled payments: 6 key thoughts Written by Laura Dyrda Spine surgeons are successfully transitioning more complex procedures to the outpatient setting, but face obstacles from payers despite the move to value-based care. At the Becker’s 17th Annual Future of Spine + Spine, Orthopedic and Pain Management-Driven ASC Conference, four panelists discussed the key trends and opportunities in spine today. The panel included Frank …

Kamala Harris

Kamala Harris to reintroduce bill tackling racial disparities in maternal health - CNNPolitics | 5/22/2019

CNN) Sen. Kamala Harris is reintroducing her 2018 bill to tackle racial disparities in maternal health, and this time it’s coming with added pressure from a House bill that mirrors her Senate legislation. The California … one price for an entire episode of care – so-called bundled payments – and financially rewarding providers with better outcomes would narrow the racial inequities. Kamala Harris says Joe Biden ‘would be a great running mate …

Paige Minemyer

Lessons from UnitedHealthcare’s stalled plan to get oncologists to prescribe generics | FierceHealthcare | 5/11/2019

by Paige Minemyer May 10, 2019 1:14pm A new study dives into a pilot payment program from UnitedHealthcare that aimed to boost generic anticancer prescriptions. (Getty/Wavebreakmedia) UnitedHealthcare piloted a program aimed at getting oncologists … than the margin of brand name drug.” RELATED: UnitedHealthcare launches bundled payments for maternity care The findings, the researchers said, offer a “cautionary tale” for insurers looking to design voluntary models like this. With voluntary …

Janice Huckaby

UnitedHealthcare launches new maternity care bundled payment program | MedCity News | 5/10/2019

Janice Huckaby, senior vice president of UnitedHealthcare’s women’s health initiatives, said maternity care is a major priority because one out of every 10 babies born in the country have a parent who is a member of UnitedHealthcare. Outside of its maternity care program, UnitedHealthcare has made a bundled payments a key part of their value-based payment strategies, especially in the Medicare space. The company – which has a stated goal …

Steve Wiggins

Remedy Partners founder Steve Wiggins explains why he’s high on bundled payments (podcast) | 4/29/2019

Steve Wiggins Steve Wiggins has seen a thing or two in his more than three decades as a healthcare entrepreneur. His Oxford Health Plans introduced “pods,” a precursor of the Accountable Care Organization and he led HealthMarket, an early player in the consumer directed health plan space. He’s carried the same themes into his current role as founder and Chairman of Remedy Partners , the leader in Medicare’s Bundled Payments for …

Jeff Meyerhofer

Home Health Care ‘Squarely in the Scope’ of UnitedHealthcare’s Bundled Payments Expansion | 4/18/2019

… in its Medicare Advantage (MA) plan networks. Home health care is primed to play a major role in that expansion, Jeff Meyerhofer, president of bundled payment solutions for UnitedHealthcare’s Medicare & Retirement division, told Home Health … acute care is a major focus area.” Advertisement The insurer’s bundled payments initiative — known as the UnitedHealthcare Care Bundles Program — builds upon its existing work for the Centers for Medicare & Medicaid Services (CMS) and the …

Sally Welborn

Carrum Health Welcomes Former Walmart Global Benefits Executive Sally Welborn to Advisory Board | PR Newswire | 11/29/2017

Worldwide Offices Carrum Health Welcomes Former Walmart Global Benefits Executive Sally Welborn to Advisory Board Expertise in Building Innovative Benefits Offering at Retailer Will Help Guide Carrum as It Expands Its Next-Generation Center of … employees worldwide, including the nationally recognized CoE program, which incorporated bundled payments for specific procedures, and a service that offered second opinions to eligible members. Earlier in her career, Welborn served for more than 11 …

Poonam Alaigh

Remedy Partners Welcomes Former Undersecretary for Health, Department of Veterans Affairs as Executive Vice President of Commercial Business Lines | Business Wire | 11/1/2017

DARIEN, Conn.- Remedy Partners, the nation’s leading bundled payment company, has named Poonam Alaigh, M.D., MSHCPM, FACP as Executive Vice President of Commercial Business Lines. She will help lead the Company’s ongoing diversification into new … platforms that enable innovative new insurance offering that rely on bundled payments for patient episodes-of-care. These new benefit plans offer health plans and self-insured employers the ability to achieve the price points …