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January 31, 2013

CMS Announces New Initiative to Improve Care and Reduce Costs for Medicare
Billings Clinic Selected to Participate in the Bundled Payments for Care Improvement Initiative

Billings, MT—Today the Centers for Medicare & Medicaid Services announced that Billings Clinic is included in a list of providers selected to begin participating in the Bundled Payments for Care Improvement Initiative. Through this new initiative, made possible by the Affordable Care Act, CMS will test how bundling payments for episodes of care can result in more coordinated care for beneficiaries and lower costs for Medicare.

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.

Today's announcement marks the start of Phase 1 of Models 2, 3 and 4. In Phase 1 (January-July 2013), over 100 participants partnering with over 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.

“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.



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