Medicare’s Bundled Payments Program Produces Mixed Results, Study Finds
Under the bundled payments program, doctors and hospitals are paid a set amount per patient for a single episode of care, such as a hip replacement, rather than paying for individual services. The report found that of the 15 types of care studied, 11 had potential to save the government money.
Modern Healthcare:
CMS' Voluntary Bundled-Payments Program Delivers Mixed Results
The first year or so of CMS' voluntary Bundled Payments for Care Improvement initiative has yielded a mixed bag of results, according to the program's evaluation report. “There have been modest reductions in Medicare episode payments for select clinical episode groups with isolated instances of quality declines and fewer instances of increased quality,” the CMS report released Monday said. The 256-page evaluation (PDF) analyzed 15 clinical episode groups; it found 11 had potential to save Medicare money. (Whitman, 9/19)
Politico Pro:
Study: Medicare's Bundled Payments Show Savings, But May Encourage More Treatment
Medicare's voluntary bundled payment program showed promise at reining in costs for an episode of care, according to a new JAMA study, the largest examination of bundled payments yet. But one researcher warns in an accompanying commentary that the program may have inadvertently encouraged unnecessary treatment, contrary to Medicare's goal of lowering overall spending through value-based care models. Lewin Group researchers focused on early findings from the Bundled Payments for Care Improvement Initiative, which has about 1,400 participating organizations that are paid a set amount for a range of episodes, including heart attacks, diabetes and more. (Diamond, 9/19)
In other Medicare news —
Miami Herald:
A Little-Known Provision Allows Private Insurance Companies To Auto-Enroll Seniors In Their Medicare Advantage Plans
A special Medicare provision that allows private health insurance companies to enroll individuals who become eligible for Medicare into their Medicare Advantage coverage is costing surprised patients lots of money, according to news reports. The little known rule, called "seamless conversion," means some health insurance companies are automatically signing members of its non-Medicare insurance plans into their Medicare plans when they reach 65, the age of Medicare eligibility. Medicare rules require a health insurance company to send a letter explaining the new coverage, which takes effect unless the member opts out within 60 days, according to Kaiser Health News. (Veciana-Suarez, 9/19)
Earlier KHN coverage: Some Seniors Surprised To Be Automatically Enrolled In Medicare Advantage Plans (Jaffe, 7/27)