OVERVIEW
Bundled payment is receiving close attention from policy makers and innovators as a way to lower healthcare costs and improve care quality. Early adoption has been slow and often difficult, but there has been a significant uptick of interest in the bundled payment model, and new programs continue to emerge across the country. The Centers for Medicare & Medicaid Services' Innovation Center has fueled much of this interest with its Bundled Payments for Care Improvement (BPCI) initiative and the January announcement that over 500 participants will begin testing four models of bundling payments this year. Increasingly, self-funded employers and large providers are implementing bundled payment contracts for high cost procedures and conditions as well.
This year, the Bundled Payment Summit will again include keynote addresses from policy makers, but emphasis will be given to national hospital and physician leaders with real-life implementation experience. Critical elements of bundled payment will be explored by speakers with on-the-ground experience and perspectives. Care redesign, the backbone of the bundled payment model, will be a central focus. Other topics include implementation case studies, data & analytics, gainsharing, employer perspectives, and how bundling fits in the spectrum of value based payment.
If you are considering bundled payment or involved in its implementation, don't miss this Summit, which is the premier conference on this topic.
LEARNING OBJECTIVES
- Identify gaps in current health plan claims payment adjudication systems.
- Identify gaps in current inpatient facilities' ability to administer internal payments within an episode payment bundle.
- Identify current software vendors that have developed capabilities and solutions to eliminate these gaps.
- Understand alternative approaches for adjudicating bundled payments.
- Explain the current issues related to insurance benefit design and bundled payment that must be considered for accurate payments. This includes how to interpret and administer current deductibles and copayments in existing health insurance benefit plans.
- Understand the importance of quality metrics for successful implementation of episode bundled payment.
- Clarify the role of quality metrics in gainsharing models.
- Describe examples of quality measurement, including the key quality measurement domains (i.e., clinical, patient experience, safety, and outcomes).
- Identify current data gaps and solutions to measure quality metrics in episode bundled payments.
- Provide examples of quality metrics for certain episode payment bundles.
- Understand the existing incentives in the current fee-for-service environment that exist for surgeons and other providers.
- Clarify the new objectives that must be met to succeed in episode bundled payment (i.e., fewer complications, lower implant device costs, etc.).
- Provide examples of the clinical redesign process.
- Understand case studies including both successes and failures in clinical care redesign for episode bundled payment.
- Understand the role of gainsharing in episode bundled payment.
- Describe different gainsharing models and their appropriateness for different clinical and organizational settings.
- Outline key legal and regulatory constraints which must be considered when developing gainsharing models.
- Describe key administrative issues that should be considered in designing a gainsharing model.
WHO SHOULD ATTEND
- Hospital CEOs and CFOs
- Medical Analytic Specialists
- Quality Improvement Executives
- Managed Care Executives
- Managed Care Contracting Experts
- Orthopedic Chiefs of Staff
- Surgeons
- Service Line Executives
- Health Plan Representatives
- Medical Directors
- Information Technology Vendors
- Health Policy Makers
- Academics
- Physicians and Physician Organizations
