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Cardiac surgery bundled payments

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
Kenan W Yount, James M Isbell, Casey Lichtendahl, Zachary Dietch, Gorav Ailawadi, Irving L Kron, John A Kern, Christine L Lau
BACKGROUND: Policymakers have proposed risk-adjusted bundled payment as the single most promising method of linking reimbursement to value rather than to quantity of service. Our objective was to assess the relationship between risk and cost to develop a model for forecasting the costs of cardiac operations under a bundled payment scheme. METHODS: All patients undergoing adult cardiac operations for which there was a Society of Thoracic Surgeons (STS) risk score over a 5-year period (2008 to 2013) at a tertiary care, university hospital were reviewed...
November 2015: Annals of Thoracic Surgery
G L Hallman, C Edmonds
In 1984 physicians at the Texas Heart Institute developed Cardiovascular Care Providers Inc, the first packaged-pricing plan for cardiovascular surgery. Under this arrangement, all services, including physician and hospital charges, are covered by a global payment package (bundled service). The resulting flat fee is lower than the sum of the individual charges. Since November 1984 the plan has been offered to the non-Medicare (less than 65 years old) population through contracts with self-insured corporations, prepaid health plans, union trusts, and foreign governments...
November 1995: Annals of Thoracic Surgery
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