bundled payment system

The key to benefiting from CMS’s bundled payment system.

Introduced in 2013, the bundled payment system from the Centers for Medicare & Medicaid Services (CMS) is one of the major drivers transforming the US healthcare industry today.

In the past, Medicaid and Medicare reimbursement was based on the volume of services rather than the quality of care provided to the patient. This fee-for-service model was widely considered responsible for creating fragmentation in care coordination and in making episodes of care more expensive. CMS’Bundled Payments for Care Improvement (BPCI) program was designed to improve coordination across providers and settings, encouraging greater collaboration to reduce costs and improve patient outcomes.

For many healthcare organizations, participating in the bundled payment system will require significant changes in the way episodes of care are managed. New technologies and expertise may be needed in order to successfully adapt to the new bundled payment system. Organizations that do not have these resources in-house may choose to work with a convener – a partner with the capabilities and expertise required to qualify for this new form of reimbursement and successfully manage the program.

When choosing a convener for healthcare bundled payments, many organizations today turn to services from naviHealth.

Navigate the bundled payment system with naviHealth.

naviHealth has been a pioneer in care transitions and post-acute management for more than 18 years. As a Cardinal Health company and the nation’s largest convener, we provide high-tech, high-touch solutions to more than 50 hospitals, managing approximately 40,000 annual episodes of care. Our CMS bundled payment team includes national consultants and former staff from the Center for Medicare and Medicaid Innovation (CMMI) who have deep experience designing and implementing programs within the bundled payment system across the US.

Our technology and clinical services for navigating the bundled payment system include:

  • Proprietary solutions and scalable technologies for improving care coordination and managing bundled payment program metrics such as SNF utilization, readmissions, PAC level of care and high-quality PAC networks.
  • Clinical services with more than 420 experienced clinicians who can help to steward patients to the next level of care.
  • Advanced analytics and reporting that can help to benchmark performance against best practices, identify areas for savings, provide NPRA support and enhance provider engagement across the continuum.

An Experienced Partner

We’ve spent more than 18 years pioneering ways to improve every aspect of care transitions for health plans, providers and patients. From discharge planning efficiencies to managing risk for payors and providers, naviHealth is equipped to provide you with a tailored suite of capabilities.

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Advantages of partnering with naviHealth on the bundled payment system.

When you rely on naviHealth services and technology for your transition to the bundled payment system, you may be able to:

  • Improve patient outcomes with more effective care coordination.
  • Enhance the patient experience by improving discharge processes and engaging patients and caregivers in the recovery process.
  • Improve financial results by reducing readmissions, lowering post-acute care costs and reducing unnecessary utilization.
  • Increase payment reform readiness with solutions that help prepare your organization for the industry-wide shift to value-based reimbursement.

Learn more about naviHealth and the CMS bundled payment system.

The statements contained on this page are solely those of the author and do not necessarily reflect the views or policies of CMS. The author assumes responsibility for the accuracy and completeness of the information contained on this page.


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