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https://www.readbyqxmd.com/read/28060238/single-institution-early-experience-with-the-bundled-payments-for-care-improvement-initiative
#1
Richard Iorio, Joseph Bosco, James Slover, Yousuf Sayeed, Joseph D Zuckerman
The Centers for Medicare & Medicaid Services (CMS) implemented the Bundled Payments for Care Improvement (BPCI) initiative in 2011. Through BPCI, organizations enlisted into payment agreements that include both performance and financial accountability for episodes of care. To succeed, BPCI requires quality maintenance and care delivery at lower costs. This necessitates physicians and hospitals to merge interests. Orthopaedic surgeons must assume leadership roles in cost containment, surgical safety, and quality assurance to deliver cost-effective care...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28055062/cost-of-joint-replacement-using-bundled-payment-models
#2
Amol S Navathe, Andrea B Troxel, Joshua M Liao, Nan Nan, Jingsan Zhu, Wenjun Zhong, Ezekiel J Emanuel
Importance: Medicare launched the mandatory Comprehensive Care for Joint Replacement bundled payment model in 67 urban areas for approximately 800 hospitals following its experience in the voluntary Acute Care Episodes (ACE) and Bundled Payments for Care Improvement (BPCI) demonstration projects. Little information from ACE and BPCI exists to guide hospitals in redesigning care for mandatory joint replacement bundles. Objective: To analyze changes in quality, internal hospital costs, and postacute care (PAC) spending for lower extremity joint replacement bundled payment episodes encompassing hospitalization and 30 days of PAC...
February 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28034906/fda-s-approach-to-regulating-biosimilars
#3
Steven J Lemery, M Stacey Ricci, Patricia Keegan, Amy E McKee, Richard Pazdur
The Biosimilar Price Competition and Innovation (BPCI) Act, enacted as part of the Affordable Care Act, created a new licensure pathway for biological products demonstrated to be biosimilar with or interchangeable with an FDA-licensed biological product (the "reference product"). FDA's approach to the regulation of biosimilars is based on the requirements set forth in the BPCI Act. A biosimilar product is highly similar to the reference product notwithstanding minor differences in clinically inactive components and there are no clinically meaningful differences between products in terms of safety, purity, and potency...
December 29, 2016: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28005410/results-of-a-medicare-bundled-payments-for-care-improvement-initiative-for-copd-readmissions
#4
Surya P Bhatt, J Michael Wells, Anand S Iyer, deNay P Kirkpatrick, Trisha M Parekh, Lauren T Leach, Erica M Anderson, J Greg Sanders, Jessica K Nichols, Cindy C Blackburn, Mark T Dransfield
RATIONALE: Approximately 20% of Medicare beneficiaries hospitalized for acute exacerbations of COPD are readmitted within 30 days of discharge. In addition to implementing penalties for excess readmissions, the United States Centers for Medicare & Medicaid Services (CMS) has developed Bundled Payments for Care Improvement (BPCI) initiatives to improve outcomes and control costs. OBJECTIVES: To evaluate whether a comprehensive COPD multidisciplinary intervention focusing on inpatient, transitional and outpatient care as part of our institution's BPCI participation initiative would reduce 30-day all-cause readmission rates for COPD exacerbations and reduce overall costs...
December 22, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27926675/improvement-in-total-joint-replacement-quality-metrics-year-one-versus-year-three-of-the-bundled-payments-for-care-improvement-initiative
#5
John M Dundon, Joseph Bosco, James Slover, Stephen Yu, Yousuf Sayeed, Richard Iorio
BACKGROUND: In January 2013, a large, tertiary, urban academic medical center began participation in the Bundled Payments for Care Improvement (BPCI) initiative for total joint arthroplasty, a program implemented by the Centers for Medicare & Medicaid Services (CMS) in 2011. Medicare Severity-Diagnosis Related Groups (MS-DRGs) 469 and 470 were included. We participated in BPCI Model 2, by which an episode of care includes the inpatient and all post-acute care costs through 90 days following discharge...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27870676/bundled-payments-for-care-improvement-lessons-learned-in-the-first-year
#6
Peter L Althausen, Lisa Mead
The Bundled Payments for Care Improvement (BPCI) initiative is the latest cost-saving program developed by the Center for Medicare and Medicaid Innovation. This model is intended to create a system for higher quality and more coordinated care at a lower cost to Medicare. It is currently an optional program for physician groups, hospitals and post-acute care providers to benefit financially from improved care models and cost containment measures. Under the initiative, organizations enter into payment arrangements that include financial and performance accountability for episodes of care...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27769886/bovine-bone-matrix-poly-l-lactic-co-%C3%AE%C2%B5-caprolactone-gelatin-hybrid-scaffold-smartbone-%C3%A2-for-maxillary-sinus-augmentation-a-histologic-study-on-bone-regeneration
#7
Delfo D'Alessandro, Giuseppe Perale, Mario Milazzo, Stefania Moscato, Cesare Stefanini, Gianni Pertici, Serena Danti
The ideal scaffold for bone regeneration is required to be highly porous, non-immunogenic, biostable until the new tissue formation, bioresorbable and osteoconductive. This study aimed at investigating the process of new bone formation in patients treated with granular SmartBone(®) for sinus augmentation, providing an extensive histologic analysis. Five biopsies were collected at 4-9 months post SmartBone(®) implantation and processed for histochemistry and immunohistochemistry. Histomorphometric analysis was performed...
October 18, 2016: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/27582485/statistical-considerations-in-evaluating-a-biosimilar-product-in-an-oncology-clinical-study
#8
Kun He, Huanyu Chen, Thomas Gwise, Sandra Casak, Steven Lemery, Patricia Keegan, Richard Pazdur, Rajeshwari Sridhara
The Biologics Price Competition and Innovation Act of 2009 (BPCI Act) established an abbreviated approval pathway for biosimilar and interchangeable biological products that was intended to balance innovation and consumer interests. The FDA has published several guidance documents to facilitate implementation of the BPCI Act. Here we discuss the role of comparative clinical studies in the assessment of clinically meaningful differences and illustrate the underlying scientific concepts with a hypothetical example of a clinical study comparing a product to US-licensed bevacizumab...
November 1, 2016: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/27531088/perioperative-optimization-of-geriatric-lower-extremity-bypass-in-the-era-of-increased-performance-accountability
#9
COMPARATIVE STUDY
Shaunak S Adkar, Ryan S Turley, Ehsan Benrashid, Sandhya Lagoo, Cynthia K Shortell, Leila Mureebe
BACKGROUND: The initiation of bundled payment for care improvement by Centers for Medicare and Medicaid Services (CMS) has led to increased financial and performance accountability. As most vascular surgery patients are elderly and reimbursed via CMS, improving their outcomes will be critical for durable financial stability. As a first step in forming a multidisciplinary pathway for the elderly vascular patients, we sought to identify modifiable perioperative variables in geriatric patients undergoing lower extremity bypass (LEB)...
January 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27357691/are-bundled-payments-a-viable-reimbursement-model-for-revision-total-joint-arthroplasty
#10
COMPARATIVE STUDY
P Maxwell Courtney, Blair S Ashley, Eric L Hume, Atul F Kamath
BACKGROUND: Alternative payment models, such as the Centers for Medicare & Medicaid Services (CMS) Bundled Payment for Care Improvement (BPCI) initiative, aim to decrease overall costs for hip and knee arthroplasties. QUESTIONS/PURPOSES: We asked: (1) Is there any difference in the CMS episode-of-care costs, hospital length of stay, and readmission rate from before and after implementation of our bundled-payment program? (2) Is there any difference in reimbursements and resource utilization between revision THA and TKA at our institution? (3) Are there any independent risk factors for patients with high costs who may not be appropriate for a bundled-payment system for revision total joint arthroplasty (TJA)? METHODS: Between October 2013 and March 2015, 218 patients underwent revision TKA or THA in one health system...
December 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27252442/alternative-reimbursement-models-bundled-payment-and-beyond-aoa-critical-issues
#11
REVIEW
A Seth Greenwald, Amy Bassano, Stephen Wiggins, Mark I Froimson
The Bundled Payments for Care Improvement (BPCI) initiative was begun in January 2013 by the U.S. Centers for Medicare & Medicaid Services (CMS) through its Innovation Center authority, which was created by the U.S. Patient Protection and Affordable Care Act (PPACA). The BPCI program seeks to improve health-care delivery and to ultimately reduce costs by allowing providers to enter into prenegotiated payment arrangements that include financial and performance accountability for a clinical episode in which a risk-and-reward calculus must be determined...
June 1, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27249717/biosimilars-here-and-now
#12
Steven J Lemery, Francisco J Esteva, Martina Weise
Congress passed the Biologics Price Competition and Innovation Act (BPCI Act) as part of the Affordable Care Act on March 23, 2010. The BPCI Act authorized an approval pathway for biosimilar and interchangeable products. It defines biosimilarity to mean "that the biological product is highly similar to the reference product notwithstanding minor differences in clinically inactive components" and that "there are no clinically meaningful differences between the biological product and the reference product in terms of safety, purity, and potency of the product...
2016: American Society of Clinical Oncology Educational Book
https://www.readbyqxmd.com/read/27244977/the-great-risk-shift-a-strategic-road-map-for-providers
#13
William Ringwood, Tawnya Bosko
Healthcare providers that are assessing their readiness to assume financial risk for care delivery should understand the full range of risk options available to them. Available options fall into two broad categories: episode-based risk (e.g., the Medicare BPCI initiative and CJR model, commercial insurance models, and direct-to-employer models) and population-based risk (e.g., shared savings models and professional or institutional capitation models). Providers also require a deep understanding of both internal and market-based factors that are essential for success under any risk option being contemplated...
April 2016: Healthcare Financial Management: Journal of the Healthcare Financial Management Association
https://www.readbyqxmd.com/read/27131095/the-physician-as-the-provider-at-risk-rolling-the-dice
#14
Stephen B Murphy, Nicholas J Bolz, David P Terry, Carl T Talmo, Michael N Fehm
BACKGROUND: There is significant need for physician innovation and leadership in health care as we adapt to bundled payment models of health care delivery. METHODS: We engaged a collective of 16 different private company orthopedic physician groups to apply to become episode initiators under BPCI models 2 and 3. The application process itself provided historical cost data, enabling each group to independently decide whether or not to proceed with the BPCI initiative...
May 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27105556/cost-analysis-of-total-joint-arthroplasty-readmissions-in-a-bundled-payment-care-improvement-initiative
#15
Andrew J Clair, Perry J Evangelista, Claudette M Lajam, James D Slover, Joseph A Bosco, Richard Iorio
BACKGROUND: The Bundled Payment for Care Improvement (BPCI) Initiative is a Centers for Medicare and Medicaid Services program designed to promote coordinated and efficient care. This study seeks to report costs of readmissions within a 90-day episode of care for BPCI Initiative patients receiving total knee arthroplasty (TKA) or total hip arthroplasty (THA). METHODS: From January 2013 through December 2013, 1 urban, tertiary, academic orthopedic hospital admitted 664 patients undergoing either primary TKA or THA through the BPCI Initiative...
September 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27049220/implementation-of-bundled-payment-initiatives-for-total-joint-arthroplasty-decreasing-cost-and-increasing-quality
#16
James P Doran, Alan H Beyer, Joseph Bosco, Peggy L Naas, Brian S Parsley, James Slover, Stephen J Zabinski, Joseph D Zuckerman, Richard Iorio
Although the Bundled Payments for Care Improvement (BPCI) Initiative began generating data in January 2013, it may be years before the data can determine if the BPCI Initiative enhances value without decreasing quality. Private insurers have implemented other bundled payment arrangements for the delivery of total joint arthroplasty in a variety of practice settings. It is important for surgeons to review the early results of the BPCI Initiative and other bundled payment arrangements to understand the challenges and benefits of healthcare delivery systems with respect to total joint arthroplasty...
2016: Instructional Course Lectures
https://www.readbyqxmd.com/read/26886810/taking-risk-early-results-from-teaching-hospitals-participation-in-the-center-for-medicare-and-medicaid-innovation-bundled-payments-for-care-improvement-initiative
#17
Coleen Kivlahan, Janis M Orlowski, Jonathan Pearce, Jessica Walradt, Matthew Baker, Darrell G Kirch
The authors describe observations from the 27 teaching hospitals constituting the Association of American Medical Colleges (AAMC) cohort in the Center for Medicare and Medicaid Innovation (CMMI) Bundled Payments for Care Improvement (BPCI) initiative. CMMI introduced BPCI in August 2011 and selected the first set of participants in January 2013. BPCI participants enter into Medicare payment arrangements for episodes of care for which they take financial risk. The first round of participants entered risk agreements on October 1, 2013 and January 1, 2014...
July 2016: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/26633254/medicare-s-bundled-payments-for-care-improvement-initiative-expanding-enrollment-suggests-potential-for-large-impact
#18
Lena M Chen, Ellen Meara, John D Birkmeyer
OBJECTIVES: Aiming to encourage care coordination and cost efficiency, the Center for Medicare and Medicaid Innovation (CMMI) launched the Bundled Payments for Care Improvement (BPCI) initiative in 2013. To help gauge the program's potential impact and generalizability, we describe early and current participants. STUDY DESIGN: We examined the cross-sectional association between BPCI participation and providers' structural and cost characteristics. METHODS: Using data from October 2013 and June 2014, we quantified changes in BPCI participation...
November 2015: American Journal of Managed Care
https://www.readbyqxmd.com/read/26308595/mandatory-medicare-bundled-payment-is-it-ready-for-prime-time
#19
Robert E Mechanic
In July, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule for a new Comprehensive Care for Joint Replacement (CCJR) program. The program would establish bundled payments for total hip and knee replacements, covering hospitalizations, professional fees, and all clinically..
October 2015: New England Journal of Medicine
https://www.readbyqxmd.com/read/24876531/drug-development-and-potential-regulatory-paths-for-insulin-biosimilars
#20
Mukul Minocha, Jogarao Gobburu
Under the Biologics Price Competition and Innovation Act (BPCI Act), a biological product may be demonstrated to be "biosimilar" if data show that, among other things, the product is "highly similar" to an already-approved biological product. Biosimilar insulins have the potential to reduce ever growing costs associated with insulin treatment by allowing competition. In this article, we describe the current drug development and regulatory paths for biosimilar insulins. Most likely basis of market approval for biosimilar insulins by the US Food and Drug Administration (FDA) and guidance for developing insulin biosimilars by European Medicines Agency (EMA) are discussed in detail...
January 2014: Journal of Diabetes Science and Technology
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