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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Medicare Test-Drives a Single-Payment System in Four States

New demonstration project bundles Part A and Part B payments for certain clinical services

In January, the Centers for Medicare & Medicaid Services (CMS) launched its test drive of a proposed bundled payment concept it hopes will generate improved quality of care and cost efficiencies. The Acute Care Episode (ACE) Demonstration project replaces fee-for-service (FFS) with global payments for orthopedic or cardiovascular inpatient procedures or both at the five participating hospitals.

A bundled payment is a single payment for both Part A and Part B Medicare services provided during a single inpatient stay. Currently, Medicare Part A pays hospitals a single predicted amount under the Inpatient Prospective Payment System for all care provided during an inpatient stay. Physicians, laboratories, and other providers with a role in a patient’s care are paid separately for services performed under Part B. (more…)

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