Bronson Methodist Hospital Selected to Partner with CMS to Improve Care, Reduce Costs for Medicare Patients
Bronson Methodist Hospital has been selected by the Centers for Medicare and Medicaid Services (CMS) for participation in its new Bundled Payments for Care Improvement initiative. The objective of this national pilot program is to improve the quality of healthcare delivery for Medicare beneficiaries by aligning the financial incentives of all providers.
Traditionally, Medicare makes separate payments to providers for each of the individual services they provide to patients for a single illness or episode of treatment. This approach can result in fragmented care that lacks coordination across providers and healthcare settings. It pays according to the quantity of services provided rather than the quality of care furnished. Research has shown that bundled payments can align incentives for providers – hospitals, post-acute care providers, physicians, and other practitioners– helping them to work more collaboratively across all specialties and settings.
Under bundled payment, organizations enter into payment arrangements with CMS in one of four models that include financial and performance accountability. These models are expected to lead to higher quality, more coordinated care at a lower cost to Medicare.
Bronson Methodist Hospital is one of just 464 hospitals nationwide selected for the bundled payment pilot program. Participating in Model 4, Bronson and its physician partners will accept a prospective lump sum payment for Medicare patients undergoing targeted cardiac, orthopedic and spine surgeries. The hospital will assume financial risk for the entire episode of care and then work closely with all members of the care team to implement evidence-based care protocols that achieve quality outcomes within the agreed upon payment structure.
“It is a major achievement for Bronson Methodist Hospital and our physician partners to be among the select group of innovators chosen to pioneer this new model of care. We look forward to this opportunity to work even more collaboratively with members of our medical staff to raise the bar on the efficiency and effectiveness of our clinical and financial performance,” said Katie Harrelson, Bronson Methodist Hospital’s chief operating officer.
The Affordable Care Act that is driving reform in healthcare is also opening the doors for a new level of partnership between hospitals and physicians that promises to help improve quality and reduce the cost of its delivery.
There is a great deal of work ahead, according to Harrelson, but it is important, ground-breaking work that will lead to measured
improvement all across the healthcare industry. “As a national leader in healthcare quality, the Bronson Healthcare system is actively involved in finding new ways to achieve highly-reliable, cost-effective care. Our focus is on delivering the right care, at the right time, in the right place for everyone we serve in southwest Michigan. What we learn through participation in the CMS initiative will contribute to a better care experience and a better value not just for Medicare patients, but for all Bronson patients and their families,” she concluded.
About CMS Bundled Payment for Care Improvement
The Bundled Payments for Care Improvement initiative includes four models of bundling payments, varying by the types of
health care providers involved and the services included in the bundle. Depending on the model type, CMS will bundle payments for services beneficiaries receive during an episode of care, encouraging hospitals, physicians, post-acute facilities, and other providers as applicable to work together to improve health outcomes and lower costs. Organizations of providers participating in the initiative will agree to provide CMS a discount from expected payments for the episode of care, and then the provider partners will work together to reduce readmissions, duplicative care, and complications to lower costs through improvement.
Today’s announcement marks the start of Phase 1 of Models 2, 3, and 4. In Phase 1 (January-July 2013), over 100 participants partnering with over 400 provider organizations, will receive new data from CMS on care patterns and engage in shared learning in how to improve care. Phase 1 participants are generally expected to become participants in Phase 2, in which approved participants opt to take on financial risk for episodes of care starting in July 2013, pending contract finalization and completion of CMS’ standard program integrity reviews.
About Bronson Methodist Hospital
Bronson Methodist Hospital, located at 601 John St. in downtown Kalamazoo, Mich., is the flagship of Bronson Healthcare, a
not-for-profit healthcare system serving all of southwest Michigan and northern Indiana. With 434 licensed beds and all private rooms, Bronson Methodist Hospital provides care in virtually every specialty — cardiology, orthopedics, surgery, emergency medicine, neurology, oncology — with advanced capabilities in critical care as a Level I Trauma Center; in neurological care as a Joint Commission certified =Primary Stroke Center; in cardiac care as the region’s first accredited Chest Pain Emergency Center; in obstetrics as the leading BirthPlace and only high-risk pregnancy center in southwest Michigan, and in pediatrics as one of only six children's hospitals in the state.
Bronson serves the largest percentage of Medicaid patients in the area and provides a substantial benefit to the community through outreach and charitable care. It is the recipient of the 2005 Malcolm Baldrige National Quality Award, the nation's highest presidential honor for quality and organizational performance excellence. In 2009, the hospital received the AHA McKesson Quest for Quality Prize awarded annually to only one U.S. hospital and joined the top five percent of hospitals in the nation to be designated a Magnet Hospital for Nursing Excellence. Bronson has been ranked in the top five percent of hospitals in the nation as a Healthgrades Distinguished Hospital for Clinical Excellence (2009-13) and as one of the nation's 100 Top Hospitals (2009-11) according to Thomson Reuters. For more information, visit bronsonhealth.com.