News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel

News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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New CMS Pilot Intends to Test Viability of a Universal Bundled-Payment Model for Inpatient Care

Nearly 500 healthcare organizations nationwide to participate in payment bundling for 48 Conditions

Medicare’s largest bundled reimbursement project to date is now launching. Clinical laboratory executives and pathologists are watching for clues as to how these bundled payment arrangements will compensate the clinical laboratory testing done on behalf of patients whose care is covered by this latest Medicare initiative.

The Centers for Medicare & Medicaid Services (CMS) will commence implementation of Phase 1 of the Bundled Payments for Care Improvement Initiative. This will be a three-year project that will test the viability of a universal bundled payment system to improve coordination and quality of care and lower costs. It is also the largest bundled-payment pilot to date, with nearly 500 participants, according to a story published by Healthcare Finance News.

One major goal of this Medicare project is to begin moving providers from the current fee-for-payment model to a single, lump-sum payment model. This would be true for all Medicare Part A and Part B services provided during one episode of care. (more…)

AMA Survey Reveals That Physician Interest Lags In ACO Participation

Many physicians say they lack specific details about the care model and how it will reimburse providers

In its own news service, the American Medical Association (AMA) reports lagging interest by physicians when they are asked about their participation in accountable care organizations (ACO). This survey of AMA members was conducted last fall.

According to an article at amednews.com (AMN), this survey found that—although many physicians are familiar with the concept—a significant number of them indicate they will either opt out of an ACO or unsure whether they will participate in an ACO.

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