How To Maximize Profit From Your Hospital’s Bundled Payments

This article was written by Lisa Miller.

Bundled payments – also referred to as episode-based payments – have significantly changed the way in which healthcare providers manage care, but it is still possible to maximize profits from your hospital’s bundled payments.

What are bundled payments?

According to the American Hospital Association, bundled payment programs are regarded as:

‘…the middle ground’ between traditional fee-for-service payments (minimal financial risk for providers) and ‘full capitation’ (full financial risk).

While Medicare has traditionally made separate payments to healthcare systems and providers for their individual services, bundled payments are growing in popularity. This means that the management of patients continues after they leave your hospital.

This episode-based payment method requires providers to use a single payment to cover end-to-end patient care—including numerous practitioners, services, and care settings, extending up to 90 days post-surgery.

Bundled payments can encourage providers to work together to improve the quality of patient care. But embracing bundled payments presents a challenge for healthcare institutions while simultaneously managing costs, care quality and patient satisfaction at the same time.

The key question is: Can your organization make money off bundled payments?

The answer is yes—and here at VIE Healthcare, we’ve figured out how.

Episode-Based Payment Consulting Services from VIE Healthcare Consulting

We view bundled payments as opportunities for profitability.

It is not an easy task as most institutions don’t receive their potential bonuses and don’t meet Medicare’s qualifications. But it is possible.

Leveraging the bundled payment system for profit requires resources, time, and innovation. VIE Healthcare provides all three in the following areas:

Bundled Payment Advisory Services

Our team of experts help hospitals to successfully manage bundled payments by adopting the following steps:

• Identifying gaps in care coverage and resource allocation.
• Reengineering and innovating new programs of care.
• Establishing post-acute care management strategies.
• Reducing the cost of supply and service offerings.
• Developing better management strategies for high-risk patients.
• Enabling end-to-end patient tracking for each episode of care.
• Improving patient satisfaction scores to reach Medicare incentives.

Comprehensive Care for Joint Replacement Model (CJR) Bundled Payment Advisory Services

The mandatory Comprehensive Care for Joint Replacement (CJR) ruling introduced in April 2016 was a game-changer for healthcare providers. This bundled payment model requires hospitals to facilitate the continuum of care with a variety of post-acute care providers, from skilled nursing facilities to rehab centers.

Joint replacement care previously ended following patient discharge. Now, your hospital is financially responsible for the entire episode of care up to 90 days post discharge.

The CJR ruling has far-reaching consequences. Hip and knee replacements are the most common inpatient surgeries for Medicare beneficiaries and often demand lengthy recovery and rehab periods.

Successful management of the CJR model requires a tremendous amount of coordination and care.

At VIE Healthcare, we understand the complexities of the CJR model and how to transform bundled payments into profit. We specialize in innovating powerful approaches to critical healthcare solutions that directly impact your success with CJR bundled payments.

We work with hospitals to enable them to master the CJR model and leverage CJR bundled payments for profit by:

• Analyzing important claims data with advanced data analytics tools.
• Identifying key cost-reduction opportunities for high-impact savings.
• Integrating advanced tools for patient care management throughout the hospital and post-acute care management.
• Mapping the patient experience for a holistic view of the patient perspective.
• Infusing innovation in the hospital’s telehealth systems for increased efficiency.
• Developing better care coordination strategies for the CJR model.
• Reengineering and redesigning important patient care processes.
• Improving hospital-wide approaches to managing high-risk patients.

Our unique approach to mapping the patient experience enables us to implement customer-driven innovations to your strategy, delivering up to 8 times your current revenue.

Maximize the profit in your hospital’s bundled payments

VIE Healthcare has been managing bundled payment regulations for our clients since 1999, ensuring they have all the right components in place to maximize profit from bundled payments. Those components include patient tracking, data analytics and best practices across your organization.

For a complimentary consultation, call our office today at 1-888-484-3332, Ext 500 or email us at info@viehealthcare.com.