|[January 31, 2013]
Integrated Healthcare Association Selected to Participate in the CMS Bundled Payments for Care Improvement Initiative as Model 4 Convener
OAKLAND, Calif. --(Business Wire)--
Today, the Centers for Medicare & Medicaid Services (CMS) announced the
health care organizations selected to participate in the Bundled
Payments for Care Improvement (BPCI) initiative, an innovative new
payment model. The Integrated Healthcare Association (IHA) was selected
to be a Model 4 facilitator and convener of five southern California
hospitals and medical center participants: Providence Holy Cross Medical
Center (Mission Hills) part of Providence Health & Services, Southern
California; Pomerado Hospital (Poway) part of Palomar Health; and three
hospitals from St. Joseph Health - St. Jude Medical Center (Fullerton),
St. Joseph Hospital (Orange (News - Alert)), and Mission Hospital (Mission Viejo).
"This presents a unique opportunity to integrate care between hospitals
and physicians to improve quality and patient satisfaction," said
Michael Hunn, senior vice president and regional chief executive of the
California region, Providence Health & Services, and IHA Board Director.
IHA's participation as a Model 4 facilitator and convener encompasses
acute care hospital stays only for total hip and knee joint
replacements. In this model, the hospitals would receive a single,
prospectively determined bundled payment for all services furnished by
the hospital, physicians, and other practitioners during the inpatient
stay and related readmissions for 30 days after hospital discharge. The
initiative applies to Medicare fee-for-service beneficiaries, and not
beneficiaries enrolled in Medicare dvantage HMOs.
"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.
About the Bundled Payments for Care Improvement Initiative
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.
Today's announcement marks the start of Phase 1 of Models 2, 3, and 4.
In Phase 1 (January-July 2013), over 100 participants partnering with
over 400 provider organizations, will receive new data from CMS on care
patterns and engage in shared learning in how to improve care. Phase 1
participants are generally expected to become participants in Phase 2,
in which approved participants opt to take on financial risk for
episodes of care starting in July 2013, pending contract finalization
and completion of CMS' standard program integrity reviews. For more
About the Integrated Healthcare Association (www.IHA.org)
IHA is a not-for-profit multi-stakeholder leadership group that promotes
quality improvement, accountability and affordability of healthcare in
California. IHA administers regional and statewide programs, serves as
an incubator for pilot programs and projects, and actively convenes all
healthcare parties for cross sector collaboration on healthcare topics.
IHA principal projects and areas of expertise include performance
measurement and analytics, the California Value Based pay for
performance program, administrative simplification, healthcare
affordability, bundled episode of care payments, and Accountable Care
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