“The only way that bundled payment creates any shared savings, which can be distributed among the participants, is if you actually redesign care to improve outcomes or reduce costs. But to redesign care, you need data. That data comes in the form of both costs and outcomes.”
– Kevin Bozic, M.D., MBA, Chair of Surgery & Perioperative Care, at the Dell Medical School at The University of Texas at Austin, in this Orthopreneur article.
The Centers for Medicare & Medicaid Services (CMS) recently proposed the Comprehensive Care for Joint Replacement (CCJR), a mandatory bundled payment model that will affect 35 percent of the U.S. population.
The transition to bundled payments is a complicated one and comes with it’s own set of challenges. While Dr. Bozic outlines a few in the article, we were happy to have been asked contribute our own thoughts to the article as it pertains to the collection of data.
Michael Barr, our vice president of sales and marketing explains exactly what CMS is looking for:
- Readmission rates
- Complication rates
- Responses from the HCAHPS survey, which captures satisfaction, service, quality of care, the patient’s mental and emotional health post-surgery, etc.
But it’s not just about readmission and complication rates.
“We believe that participant s should look beyond the required metrics and understand the variables that would contribute to readmission, for instance, information about the case approach, the surgeon performing the case, implants used, assistants who were in the room—any data variable that can be held in discrete fields that can be searched after the fact,” he says.
Truth be told, the transition to bundled payments might make sense for many whether you are affected by the CMS mandates or not. Private alternative paid models are a solution to preparing for changes in CMS one way or another as it is predicted that is the route Medicare will take by 2020 – 100 percent alternative paid models.
Collecting the right data is key to the process. Where to start is the challenge.
Your data partner should have experience in designing datasets that will have the greatest impact with the highest number of stakeholders. They should also be mindful of how to maximize patient compliance. Getting started on the right course and staying committed to that plan is important to achieve the long-term benefits of outcome data collection.