Writing for MedCity News, Venture Valkyrie Consulting’s Lisa Suennen opines that — due to the recent announcement from CMS that hospitals must develop bundled payment programs for cardiovascular procedures in addition to hip and knee replacement procedures — the health care industry experienced a watershed in the shift toward the value-based payment model:
[W]e will all look back at this July 25th announcement as the tipping point in the movement towards value-based payments because of the number of people it impacts on all sides of the care equation: patients, providers, payers, device manufacturers, pharmaceutical companies—the whole gamut of stakeholders. Forcing bundled payments on major orthopedic categories was the first ring of the bell. And now the cardiovascular bundles are a fundamental stake through the, ahem, heart of hospital profitability.
Suennen points out that in mandating bundled payments, CMS has two objectives in making such a move. First, the agency aims to improve the patient experience. Second, it strives to reduce costs paid by the federal government and taxpayers.
Bundled payments are the agency’s way of putting the onus of creating more efficiency in care delivery and improving care coordination squarely on the hospitals, many of which aren’t readily equipped to make such a sea change to their current business practices.
Whether July 2016 truly marked the tipping point toward value-based payment models remains to be seen — but there’s no question industry leaders are sitting up and taking CMS seriously.