60 seconds with ... Avalere Health Director Brian Fuller

Share this article:
Brian Fuller, Director, Avalere Health
Brian Fuller, Director, Avalere Health

Q: The government is notifying new participants in the Bundled Payments for Care Improvement initiative. Do you expect more post-acute providers in this latest round?

A: Yes, and a more representative cross-section of the industry. Plus, we anticipate additional participation that involves hospitals with more explicit post-acute care risk-sharing. 

Q: What are post-acute participants focusing on, as they will take on financial risk next year?

A: Translating Medicare claims data into care redesign plans. The efforts include ensuring placement in the most appropriate setting, lowering SNF average length of stay, readmissions and possibly leveraging home health. They are boosting nursing and physician coverage, post-discharge follow-up, downstream partnerships, and patient flow and performance monitoring.

Q: What else should providers know about evolving payment systems?

A: It's not just bundled payments or Medicare. Commercial payers and health plans are engaged with post-acute providers on arrangements that involve only upside or upside and downside risk for performance on metrics. Medicare Advantage and commercial plans are important experimentation approaches, which you should not leave out of your strategy.

Share this article:

More in News

CMS expands therapy payment research

The government is expanding its research into alternative therapy payments, to consider more holistic changes to the way Medicare reimburses skilled nursing facilities, the Centers for Medicare & Medicaid Services announced Tuesday.

CDC tightens Ebola guidelines for healthcare workers

The Centers for Disease Control and Prevention has issued more stringent guidelines for how healthcare workers should interact with Ebola patients, following an outcry from nurses and other professionals.

Nonprofit providers face alarming market forces, must rally, LeadingAge chairman says

Nonprofit providers face alarming market forces, must rally, ...

Nonprofit long-term care providers must work together to address alarming trends, or their market share could plummet and the sector as a whole could falter, LeadingAge Chairman David Gehm told ...