Experts Raise Concerns About Medicare’s Efforts To Bundle Payments In Wake Of New Study
“CMS is doubling down on bundled payments without a lot of evidence,” Dr. Chad Ellimoottil, an assistant professor at the University of Michigan who has studied alternative payment models, tells Modern Healthcare. Implementing payment reforms does not “flip a switch and all of a sudden hospitals are way more efficient.”
Rapid Adoption Of Bundled Payments Remains An Act Of Faith
Bundled payments, by some estimates, are taking off more quickly than any other value-based payment scheme. But a dearth of data obscures the model's actual effect on the costs and quality of healthcare, a challenge underscored in the latest report on Medicare's voluntary Bundled Payments for Care Improvement initiative. ... Medicare's Comprehensive Care for Joint Replacement model, which began in April and is mandatory for 800 hospitals across 67 metropolitan areas, bundles payments for hip and knee replacements. In July, the CMS proposed introducing mandatory bundled payments for bypass surgery and heart attacks in 98 metro areas. Overall, the administration aims to tie 90% of traditional Medicare fee-for-service payments to quality or value by 2018. (Whitman, 9/22)
And on the issue of enrolling for Medicare Advantage plans --
North Carolina Health News:
Letter from Insurer Could Contain Unwanted Medicare 'Conversion'
State insurance officials say that a letter from someone’s current insurance company could soon notify the beneficiary that the person has been automatically enrolled in a private “Medicare Advantage” plan instead of traditional Medicare. Under the process called “seamless conversion,” the letter says, the person has to take the active step of opting out to prevent the “conversion” from taking effect. (Goldsmith, 9/26)