Bundled payments Every episode is an opportunity... to do what’s best for the patient. We have your back.

 

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Bundled payments

Performance Solutions is a leading orthopaedic convener, supporting hundreds of physicians and hospitals, bearing the administrative burden and providing the tools, guidance and best practices to drive success under the program.

  • Core focus in orthopedics
  • Experts in Bundled Payments
  • Partners for Success


The Centers for Medicare and Medicaid Services. (CMS) and Center for Medicare and Medicaid Innovation (Innovation Center) released a new voluntary episode payment model, Bundled Payments for Care Improvement (BPCI) Advanced program in January, 2018.  with a deadline of March 12, 2018 to apply. The initiative aims to build upon previous bundled payment programs to improve the quality of care for Medicare patients while reducing healthcare costs. The initial cohort began on October 1, 2018 with the next opportunity to apply to participate in 2019 to start in the program in January, 2020.    

Performance Solutions partnership and success in the initial BPCI program and with CJR customers nationwide has led to the development and continuous enhancement of data analytics capabilities and care coordination tools that allow easier management of the episode of care. 

Performance Solutions partnership and success in the initial BPCI program and with CJR customers nationwide has led to the development and continuous enhancement of data analytics capabilities and care coordination tools that allow easier management of the episode of care

What is a bundled payment? learn more

Episode Performance Manager (EPM) is Performance Solutions' web-based platform to help ease the burden of analyzing data to ensure success.

RecoveryCOACH is Performance Solutions Care Coordination and Patient engagement platform that helps track patients throughout the episode of care and gauge progress in the program.

As a member of the Stryker BPCI Advanced Convener, customers get access to RecoveryCOACH, a patient engagement and care coordination web-based tool. To help with patient engagement in RecoveryCOACH we created a 2-minute educational video which explains the benefits of RecoveryCOACH. Please view the video below:


Bundled Payments for Care Improvement (BPCI) Advanced

What we offer:

Comprehensive project management

  • Proactive planning
  • Task execution and resource accountability
  • Deadline adherence
  • Verification of BPCI A results & work directly with CMS to resolve any inaccuracies

BPCI compliance support

  • Report required data to CMS
  • Supply additional information requested by CMS
  • Monitor CMS webinars, legislative news and other communications for the latest program developments and communicate important information to practice leadership

Stakeholder education

  • BPCI Advanced education for physician leadership and staff.

Care Redesign

Our goal is to help provide the right care, at the right place and the right time.

  • Optimize and educate patients and caregivers
  • Pre-op automated risk assessment
  • Predetermined discharge plan based on predictive risk score
  • Efficient patient tracking and managing by exception

Care Coordination and Patient Engagement - RecoveryCOACH™: a web-based platform

  • Reduce calls by engaging directly with the patient
  • Allows you to manage by exception
  • Predict patient risk and develop the appropriate care plan
  • Manage & track post-acute care plan, partners, and LOS
  • Generate real-time, leading indicator reports to drive change quickly

Episode Data Collection and Analytics - Episode Performance Manager®

  • Quarterly data review calls
  • Visualize claims data and identify opportunities to help reduce costs
  • Drill into episode costs down to the physician and patient level
  • Monitor SNF and Home Health quality rating, utilization and results on key cost metrics
  • Produce individual surgeon scorecards to communicate performance against goal

Comprehensive Care for Joint Replacement (CJR)

800+ hospitals in the 67 Metropolitan Statistical Areas (MSAs) under the mandatory bundled payment model for Total Joint Replacement of the lower extremities need to outperform regional hospitals year over year. Leveraging episode data to align care providers, clinical protocols and care pathways in a patient-centric model will drive success under CJR. Reducing variation and driving transformation in care delivery across your entire total joint episode will take provider alignment and collaboration. When quality of care improves, variation and cost reductions across the episode are recognized.


Our implementation programs are designed to maximize results and reduce risk under CJR.

Leading impactful change through risk-based programs

Implementing optimal payment and risk-based strategies is crucial when shifting away from traditional fee-for-service payment models toward value- and risk-based models. Today’s payors (both Medicare and commercial) are looking to share in the risk of providing care for patient populations with providers in return for potential upside reward.

Physician - hospital - payor alignment is necessary for the development and implementation of a viable and sustainable risk-based strategic plan.

Performance Solutions will help develop bundled payment strategies, develop and execute Accountable Care Organizations (ACO’s), develop gainsharing agreements and organize Clinically Integrated Networks (CIN's).


Payors

Starting bundled payment programs with the hospitals and physicians in your market may drive necessary cost savings. Embracing bundled payments is a commitment to developing and implementing comprehensive systems of care that continue for the duration of the bundle and the overall improvement in quality of care for patients.

Performance Solutions is experienced in all of the CMS bundled payment programs, including as a BPCI Awardee Convener, and is now working with hospitals, physician groups and private payers on commercial bundled payments. Performance Solutions has the expertise, support teams and data analytic solutions to address the four critical bundled payment success factors: understanding your data; re-designing care; aligning the physicians; and engaging the patients. The right support and tools in the hands of your bundled payment partners will drive efficiency and cost reduction across the entire value chain - there is no need to reinvent the wheel.

The Performance Solutions team is excited to work with you to customize or co-develop new programs to meet your specific needs.

Demo Episode Performance Manager today