Rockville Centre, NY – The Centers for Medicare & Medicaid Services (CMS) selected Catholic Health Services (CHS) to participate in the Bundled Payments for Care Improvement initiative. Through this new program, in accordance with the Affordable Care Act, CMS will test how bundling payments can result in more coordinated care for health services for patients and lower costs for Medicare.
“We look forward to demonstrating our ability to deliver the highest quality care to patients in a safe and efficient manner, with positive results to both the patients we care for and Medicare,” said Joel Yohai, MD, Executive Vice President for Medical Affairs and Chief Medical Officer. “Our care innovations are focused on reducing variations in care, basing care protocols on evidence-based best practices and reducing complications and readmissions during the post-acute phase.”
Bundling payment for services that patients receive across a single episode of care, such as heart bypass surgery or a hip replacement, is one way CMS hopes to encourage doctors, hospitals and other health care providers to work together to better coordinate care for patients both when they are in the hospital and after they are discharged. It is believed that following this approach can help improve patients’ health and quality of care, as well as lower costs.
“The objective of this initiative is to improve the quality of health care delivery for Medicare beneficiaries, while reducing program expenditures, by aligning the financial incentives of all providers,” said Acting Administrator Marilyn Tavenner.
The Bundled Payments for Care Improvement initiative includes four models of bundling payments, varying by the types of health care providers involved and the services included in the bundle. Depending on the model type, CMS will bundle payments for services beneficiaries receive during an episode of care, encouraging hospitals, physicians, post-acute facilities, and other providers as applicable to work together to improve health outcomes and lower costs. Organizations of providers participating in the initiative will agree to provide CMS a discount from expected payments for the episode of care, and then the provider partners will work together to reduce readmissions, duplicative care, and complications to lower costs through improvement.
CHS will test the initiative across Long Island, partnering with its extensive network of physicians, hospitals and post-acute care providers and focusing on episodes of congestive heart failure and joint replacement. Each of CHS’s six acute care hospitals will participate in the bundled payment program. These include Good Samaritan Hospital Medical Center, Mercy Medical Center, St. Catherine of Siena Medical Center, St. Charles Hospital, St. Francis Hospital and St. Joseph Hospital.
“CHS is well positioned for this project, as our services span the continuum of care from hospital to skilled rehab and nursing to home care. We will collaborate with our medical staff and other post-acute providers in the community,” explained CHS Executive Vice President and President and CEO for Continuing Care Joseph Tomaino. “We will be responsible for care during the acute hospitalization and the following three months.”
Catholic Health Services (CHS) is an integrated system encompassing some of the region’s finest health and human services agencies. With six acute care hospitals, three nursing homes, a home health agency, hospice, a community-based agency for persons with special needs and a regional lab, CHS’s high standards have resulted in a nearly 24% market share.