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.