Wednesday, March 6, 2013

CoxHealth selected as a participant awardee in CMS Bundled Payments for Care Improvement initiative

CoxHealth has been selected as a participant awardee in Phase 1 of the Centers for Medicare and Medicaid Services Bundled Payments for Improvement initiative. The initiative changes the way participants are paid for the services they provide, bundling payments to encourage health providers to work together to improve quality while reducing costs.

The initiative includes four models of bundling payments, varying by the types of health care providers involved and the services included in the bundle. CoxHealth is participating in Model 2. 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 to work together to improve health outcomes and lower costs. Organizations of providers participating in the initiative agree to provide CMS a discount from expected payments for the episode of care, and then the provider partners work together to reduce readmissions, duplicative care and complications to lower costs through improvement.

“We are excited to be participating in opportunities to deliver high quality, efficient healthcare to Medicare beneficiaries in our community,” said Jeffrey Bond, president and CEO of Cox HealthPlans.

In Phase 1 (January-July 2013), more than 100 participants partnering with more than 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.

"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.