The Centers for Medicare and Medicaid Services is seeking participants for new rounds of its Bundled Payment programs under Medicare, Medicaid and Childrens Health Insurance Program.
Under bundled payment, providers in a single organization or working with other providers accept a specific payment for an entire episode of care, rather than reimbursement of individual services given during the course of treatment. Providers may also commit to meeting certain quality metrics. The goal is to reduce costs while increasing quality.
There are four models to the programs and Model 1, a retrospective payment for an acute inpatient hospital stay, started in April 2013. Models 2, 3 and 4 started testing in October 2013 and more participants are being sought.
Model 2, is a retrospective bundled payment for hospitals, physicians and post-acute providers for a coordinated episode of care. Model 3 is a retrospective bundled payment for post-acute care where the episode does not include the acute inpatient hospital stay, according to CMS. Model 4 is a prospectively administered bundled payment for an acute inpatient hospital stay and related readmissions.
In a notice available here, CMS believes increasing participation on Models 2, 3 and 4 will bring a more robust data set and improve evaluation of the models. The agency is accepting submissions during an Open Period ending on April 18, 2014. Organizations wishing to participate in more than one model should submit a separate request for each model.
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