Medicare Bundle Care

The new buzz word in healthcare today is Bundle care.  What does this mean for you and your healthcare?  When I hear the word bundle I think of my cable company providing me internet, phone and TV services.  Today the word bundle has hit our health care and the meaning is the same…it just applies to your doctor, hospital, skilled nursing facility and home health care. 

Traditionally, Medicare made separate payments to providers for each individual service they furnished to Medicare beneficiaries.  Studies have shown that this approach resulted in fragmented care with little coordination between providers concerning the care of patients. Aligning care coordination between providers – hospitals, physicians, skilled nursing and home care- allows them to work closely together across all specialties and settings of care to improve the care to all Medicare patients.

January, 2013 Medicare announced the health care organizations selected to participate in the Bundled Payments Care Improvement (BPCI) initiative. Developing the concept of “bundles” is designed to help health care providers to deliver the best possible care for patients undergoing a particular treatment, surgery or hospitalization.  Who were these organizations?  Physicians, Hospitals, Skilled Nursing Facilities, all aspects of those who provide health care to those who are covered under the traditional Medicare insurance program.  The initiative is designed to change care models for Medicare beneficiaries.  Changes will include sharing clinical information between providers which will allow each of them to know your specific health care needs, develop best care practices for every provider, and increasing education. 

So how do you know if you are part of this new care redesign with Medicare and how does this effect your care?  Only those who have enrolled in traditional Medicare part A & B may be included.  Those who enrolled in a Medicare replacement plan, Medicare Railroad plan or have end-stage renal disease are not eligible to participate.  If your health care provider is part of the Bundle Payments Care Improvement you will receive a notification letter. 

What should you expect from your “bundle” health care provider?  They will be working more closely with your physician and/or hospital so you get better care following your hospital stay.  By working together, your health care providers will plan more efficient, high quality care as you undergo treatment.  Medicare will monitor your care to make sure you and others get high quality care.  Your provider will conduct follow up calls for up to 90 days to ensure you have transitioned well at home and will help if you have problems or concerns after discharge. 

So what is next?  Medicare has chosen 800 hospitals across the country to participate in the BPCI for hip and knee replacements.  This is the first monumental move to project this project across the country as required rather than voluntarily participating.  Medicare expects that at least 25% of Medicare recipients will participate in a bundle care project by the year 2017, 50% by 2018 and 75% by 2019. 

For more information call 1-800-MEDICARE or visit www.innovation.cms.gov.

Comments

Related Articles

Order your printed copy of Senior Directory today!

Still enjoy flipping through the pages of a printed copy? So do we! Click on the button below to start receiving Senior Directory right at your doorstep!

Order Your Copy

I prefer the digital copy, please.