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Organizing data for bundled payments

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This HealthAffairs piece says that the ”most effective step CMS could take toward helping hospitals prepare for bundled payments would be to make historical Medicare episode payment data for their patient populations available to each acute care hospital. The data could be organized into three levels, each progressively more detailed, to allow hospitals to select and analyze populations with high episode payments:

  1. “Total price-standardized and risk-adjusted payments for episodes, defined by clinical groupings of DRGs, compared to regional and national benchmarks.
  2. “Payments for categories of services in each of the diagnosis-related-group-defined episodes, including the index hospitalization and specific types of post-discharge services, compared to regional and national benchmarks.
  3. “Detailed claims within each service category of the episode, to facilitate the analysis of factors that contributed to higher payments and development of strategies (e.g., developing partnerships with key post-acute care providers) and interventions to improve performance.”

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