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Mandated Bundled Payments Compel Hospitals to Rethink Post-Acute Care

Medicare's Comprehensive Care for Joint Replacement ("CCJR") program signals an evolution in payment that demands a strong strategic response from hospitals and health systems.To this end, hospitals should monitor the performance of their post-acute care partners using performance measures established with input from the partners. Measures such as complication rates, length of stay, and readmission rates (i.e., major drivers of cost) should be monitored and reported in as close to real time as possible. Additional measures such as patient experience of care, ancillary use, and physician utilizational so should be tracked, but with the understanding that they are secondary to the economics of the bundle.

Cross-continuum bundles succeed when there is concurrent information exchange through technology leveraged across settings and providers. A checklist can serve as an easy first-phase approach to ensure smart execution, especially when systems are not yet talking. Although systems to effectively track and monitor measures ideally will involve integration among health information platforms that capture actual utilization and cost data, most post-acute care measurement is likely to be manual or self-reported.

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Bundled Payments, CCJR, The Camden Group, HFMA

(Introductory paragraphs courtesy of HFMA)

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