Total episode payments declined but the Medicare program lost big from 2013 to 2016 with Bundled Payments for Care Improvement.
The total cost was nearly $290 million.
Model 2, the most commonly used track by providers, cost Medicare $268 per care “event” while Model 3 cost $925 per event.
“Despite these encouraging results, Medicare experienced net losses under BPCI after taking into account reconciliation payments to participants,” analyists with the Centers for Medicare & Medicaid Services noted. “Technical implementation issues, including the specification of appropriate target prices, contributed to these net losses. We are optimistic that Medicare will achieve net savings under a new episode-based Advanced Alternative Payment Model, BPCI Advanced, because it addresses the challenges BPCI experienced.”
Researchers with the Lewin Group said that a CMS decision to not penalize providers for lack of performance took away downside risk, dragging down the odds of Medicare saving money.
Under the bundling initiative, providers across the continuum of care split reimbursements for each episode of care. The goal is to lower costs for the government by rewarding groups that hit spending goals and penalizing those that don’t.
From the November 2018 Issue of McKnight's Long-Term Care News
