Long-term care providers are participating in 'most ambitious test' of bundled payments, CMS announc

Skilled nursing facilities and home health agencies are among 232 healthcare providers that have entered into agreements to take part in the Bundled Payments for Care Improvement initiative, the Centers for Medicare & Medicaid Services announced Thursday.

CMS described this initiative as “the largest and most ambitious test ever of a bundled payment model in Medicare or any other payer.”

The announcement came as a one-year update, as CMS first announced program participants in January 2013.

The initiative includes four different bundled payment models. Providers participating in those models that cover a period of post-acute care had a choice of entering into an agreement that became effective in October 2013 or January 2014.

Through the initiative, providers receive a single payment to cover an episode of acute and post-acute care for a particular service, such as hip replacement. They are eligible to share in savings achieved through care coordination.

CMS released the bundled payment participation figures at the same time that it shared the latest data on accountable care organizations, another type of payment model in which coordinated providers can share in the savings they achieve.

Out of 114 accountable care organizations eligible for these bonus payments during the first year of the Medicare Shared Savings Program, only 29 received them, according to the CMS data. These networks will receive a total of $126 million. 

These results are “within the range originally projected,” according to CMS. Considering the investments in data systems and the changes in service delivery that participants faced in the first year, the results are evidence that the program is heading “in the right direction,” CMS Principal Deputy Administrator Jonathan Blum said on a call with reporters.

Pressed about the results that might appear underwhelming, Blum repeatedly stressed that the ACO model is only one of several new payment models being tested — a point underscored by the agency’s emphasis on the scale and ambition of the Bundled Payments for Care Improvement program.