UAB participating in CMS care, cost improvement initiative

UAB Hospital participating in Centers for Medicare and Medicaid Services initiative designed to improve patient care, lower health care costs

The Centers for Medicare & Medicaid Services (CMS) has announced that the University of Alabama at Birmingham (UAB) Hospital, along with more than 500 other organizations, will begin participating in its Bundled Payments for Care Improvement initiative. UAB is the only hospital in Alabama participating in the Bundle pilot program.

hospital_at_night_storyThrough this new initiative, CMS will test how bundling payments for episodes of care can result in more coordinated care for beneficiaries and lower costs for Medicare.

“The objective of this initiative is to improve the quality of health care delivery for Medicare beneficiaries, while reducing program expenditures, by aligning the financial incentives of all providers,” said Acting Administrator Marilyn Tavenner.

The Bundled Payments for Care Improvement initiative includes four models of bundling payments, varying by the types of health care providers involved and the services included in the bundle. Depending on the model type, CMS will bundle payments for services beneficiaries receive during an episode of care, encouraging hospitals, physicians, post-acute facilities, and other providers as applicable to work together to improve health outcomes and lower costs. Organizations of providers participating in the initiative will agree to provide CMS a discount from expected payments for the episode of care, and then the provider partners will work together to reduce readmissions, duplicative care, and complications to lower costs through improvement.

UAB will be participating in the COPD/bronchitis/asthma bundle of the initiative. UAB administrators elected this model because these are chronic conditions that involve interprofessional collaboration among several disciplines for the coordination of patient care, both in the hospital and in the post-acute care setting.

“COPD is one of the most common lung diseases, and Alabama has some of the highest COPD rates in the nation,” said UAB Health System CEO Will Ferniany, Ph.D. “By participating in this initiative, it is our hope that we can be at the forefront of developing a financially sound model that is efficient for both CMS and providers while improving health care delivery — for the people of Alabama and patients suffering from COPD across the nation.”

The announcement marks the start of Phase 1 of Models 2, 3 and 4.  In Phase 1 (January-July 2013), more than 100 participants partnering with more than 400 provider organizations, will receive new data from CMS on care patterns and engage in shared learning in how to improve care. Phase 1 participants are generally expected to become participants in Phase 2, in which approved participants opt to take on financial risk for episodes of care starting in July 2013, pending contract finalization and completion of CMS’ standard program integrity reviews. 

To see the list of awardees for Model 1 and participants for Phase 1 of Models 2, 3, and 4 visit the CMS website.

 
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