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Seeming success in a CMS bundled-care pilot

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Although the jury remains out on many bundled-payment programs, the success of a Centers for Medicare & Medicaid Services pilot program at Baptist Health on San Antonio in saving $1 million in its first year while improving outcomes has led 360 more providers to  try the program. Further,  a total of 1,755 other providers will partner with them and assume the same financial risk for care episodes.

The project was centered on joint replacements. Under the pilot with CMS, Baptist received a lump sum for each procedure priced at 3 percent below what it normally received from Medicare to perform the procedures.  “If it kept costs below that threshold and maintained high-quality outcomes, Baptist got to keep the difference,” FierceHealthFinance reported.

CMS reported that changes to in-hospital processes saved nearly $300 per patient, saving about $1.1 million based on the number of patients that received treatment through the  bundle.

“Baptist Health also took hard looks at nearly automatic referrals for physical therapy, home nurse visits and nursing homes. Such referrals account for nearly half the cost of a joint replacement procedure. Instead, under the pilot program the patient was more likely to receive therapy at home. The health system also re-examined the use of particular blood thinners, compression stockings and canes for each patient, ” Fierce reported.



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