CHICAGO – Bundled care payments are a hot topic among physicians as the Centers for Medicare and Medicaid Services continues to roll out its bundled payment pilot program.
But does the method really improve quality and enhance care delivery?
Physician leaders with the Arkansas Health Care Payment Improvement Initiative may have the answer. Arkansas was the first to implement a statewide payment reform initiative that rewards doctors for quality care and enables them to access data about overall care quality delivered during a set time period.
Dr. William Golden, medical director of the Arkansas Division of Medical Services, Department of Human Services, spoke about the initiative and its impact at the annual meeting of the Healthcare Information and Management Systems Society.
The initiative was launched in 2011 and includes partnerships between the Arkansas Department of Human Services, Arkansas Blue Cross and Blue Shield, and QualChoice of Arkansas.
The program enables physicians to share in the savings or excess costs of an episode, depending on their performance for each episode. For some episodes, health providers submit information through the billing system’s provider portal, a HIPAA-compliant online tool that collects data about overall care and performance. The portal allows hospitals, physicians, and other providers to submit a set of quality metrics data that will to be tied to the initiative’s financial incentives.
The tool also allows doctors designated as principal accountable providers to access reports about their average quality, costs, and utilization for care episodes.
During the payment initiative’s first phase, insurers introduced five episodes of care, including upper respiratory infections, total hip and knee replacements, congestive heart failure, attention deficit/hyperactivity disorder, and perinatal.
In a video interview, Dr. Golden discusses the initiative, the road to build its design, and how the program has affected physicians and patients.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel.
On Twitter @legal_med