Bundled Payments for Care Improvement: Preparing for the Medical Diagnosis-Related Groups

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Abstract

BACKGROUND

The Centers for Medicare and Medicaid Services Innovation Center introduced the Bundled Payments for Care Improvement (BPCI) initiative in 2011 as 1 strategy to encourage healthcare organizations and clinicians to improve healthcare delivery for patients, both when they are in the hospital and after they are discharged. Mercy Health Saint Mary’s, a large urban academic medical center, engaged in BPCI primarily with a group of medical diagnosis-related groups (DRGs).

OBJECTIVES

In this article, we describe our experience creating a system of response for the diverse people and diagnoses that fall into the medical DRG bundles and specifically identify organizational factors for enabling successful implementation of bundled payments.

RESULTS

Our experience suggests that interprofessional collaboration enabled program success.

CONCLUSIONS

Although still in its early phases, observations from our program’s strategies and tactics may provide potential insights for organizations considering engagement in the BPCI initiative.

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