Health Reform and Bundled Payments

CMS declared intent to deny reimbursement for preventable readmissions that occur within 30-days of discharge encourages bundling.

Health Reform is changing revenue and reimbursement structures. Section 3023 includes funding for a $10 billion national pilot program on payment bundling through the CMS Center for Health Care Innovation. Integrated Healthcare Networks of hospitals, physicians and ancillary providers anticipate shared-risk arrangements with insurers and third party payors. CMS intends to define Accountable Care Organizations, a distant relative of HMO’s in fall 2010. Beginning January 1, 2012, qualified Accountable Care Organizations will begin sharing in Medicare cost savings.

 

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