Bundled Payments Acute Care Deadline Extended

The Centers for Medicare & Medicaid Services (CMS) has extended the deadline for Model 1 of its Bundled Payments for Care Improvement program, giving providers for whom the episode of care is the acute care hospital stay only until Oct. 6 to apply. Sept. 22 was the original deadline.

Under the Bundled Payments for Care Improvement initiative, several items or services would be paid for as a single entity beginning Jan. 1, 2013. The initiative is different from the National Pilot Program on Payment Bundling, a part of the Affordable Care Act. Managed through the CMS Innovation Center, the program is designed to improve patient care and foster a patient-centered approach, the agency says.

Certified Inpatient Coder CIC

Several situations, or models, are being developed. Applicants propose the target price for an episode of service, which would be set by applying a discount to total costs for a similar episode of care as determined from historical data. Participants in these models would be paid for their services under the traditional fee-for-service system. After the conclusion of the episode, the total payments would be compared with the target price. Participating providers may then be able to share in those savings.

According to CMS, applicants for these models would also decide whether to define the episode of care as the acute care hospital stay only (Model 1); the acute care hospital stay plus post-acute care associated with the stay (Model 2); or just the post-acute care, beginning with the initiation of post-acute care services after discharge from an acute inpatient stay (Model 3). Under the fourth model, CMS would make a single, prospective bundled payment that would encompass all services furnished during an inpatient stay by the hospital, physicians, and other practitioners.

The new deadline for models 2-4 applications is Nov. 4, 2011.


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