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Data Transparency Leads to Success in Bundled Payments, Harden Says at Conference

01/27/16

  10:30:00 pm, by MedBen5   , 529 words,  
Categories: News, Reporting, Hospitals, Cost savings, MedBen Analytics, Bundled Payments

Data Transparency Leads to Success in Bundled Payments, Harden Says at Conference

"Data transparency will help drive success in the new world of value-based and bundled payments." That's the message MedBen President and COO Kurt Harden shared with hospital, health system, and provider group representatives at the 2nd Annual Bundled Payment Implementation Forum on January 25.

“The old world of health payments has been about delayed, withheld, filtered, and segmented information,” Harden told conference attendees. "The new world will need more on-demand, widely dispersed, useful, and comprehensive data use."

Kurt Harden

Bundled Payments
Harden was among the featured speakers at the conference, which offered professional perspectives on bundled payments, an increasingly common form of provider compensation.

As the Centers for Medicare and Medicaid Services (CMS) move away from a fee-for-service reimbursement model, a variety of alternative reimbursement models are being implemented. CMS Director, Sylvia Burwell says that 90% of the CMS payments will be in the form of alternate payments by 2018 – among them, bundled payments.

In a bundled payments model, hospitals, health systems, and providers are incentivized to meet payment targets for entire episodes of care. For example, the payment for a hip or knee replacement would cover all elements of the procedure, including the hospital stay, replacement joint, physician charges, anesthesia, most medications, and care for up to 90 days following discharge from the hospital.

Early indications from a variety of nationwide tests on this approach have shown success in controlling costs and improving outcomes for patients. As a result of those successes, CMS announced a mandatory lower joint replacement bundle to be implemented in 67 markets across the U.S. This mandatory bundle, known as the Comprehensive Care for Joint Replacement model, or CJR, will affect over 800 hospitals nationwide who perform lower joint replacements on Medicare recipients.

“Start with the end in mind”
“When outlining your data needs for bundled payments, it is best to start where health systems have seen the most success controlling costs,” Harden explained to conference participants. “Bundled payments bring a rich new source of longitudinal data on medical care and associated costs."

Providers will want to focus on information that will help them succeed in this new payment world, Harden observed. “Look at data on length of stay variations, post-acute care settings, readmissions, and supply costs. Organizations that have been successful with bundled have used this information to improve clinical pathways to lower costs and improve care,” he said.

Harden sees this work as benefitting all MedBen clients. “These alternative payments methods will continue to grow in all areas of health care financing,” he emphasized. “Our analytics team is using the knowledge we gain from this new line of business to help innovate new savings approaches for all of our clients.”

MedBen Analytics
In 2015 MedBen formed a new subsidiary, MedBen Analytics, dedicated to using Medicare claims data to provide clients with highly actionable insights necessary to improve care. MedBen Analytics saves clients money by using a proprietary analytics engine that delivers information quickly and effectively, via an online portal in easy-to-understand and interactive reports.

For example, one MedBen client used the MedBen Analytics skilled nursing report to detect an overutilization issue. The client modified their clinical pathway and saved nearly $500,000 on lower joint replacements.

Harden can be reached at kharden@medben.com.

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