The distribution of gainshare checks to collaborating Baptist Health System physicians was a 'Hallmark second' of the CMS Acute Care Episode (ACE) pilot, recollects Michael Zucker, senior vice chairman and chief improvement officer. The ACE pilot examined bundled funds throughout particular episodes of care.
For organizations contemplating participation in the 2011 CMS Bundled Funds initiative, Case Study in Bundled Funds: The Baptist Health System Experience is important studying earlier than submitting letters of intent and purposes for CMS's new bundled cost program.
This 24-web page report paperwork the care cost expertise of Baptist Health System in the CMS ACE demonstration pilot, which aligned cost for providers delivered throughout episodes of care or "bundled" care. ACE targeted on the cardiac and orthopedic analysis-associated group (DRGs), two of the general public payor's most frequent and largest value illness areas.
Knowledge from the ACE demonstration helped to put the groundwork for the CMS Bundled Funds initiative introduced in August 2011.
A serious player in the cardiac area, having a bit of over a 3rd of the cardiac market share, Baptist Health noticed in the ACE demo a chance to realize market share, align suppliers in high quality and effectivity efforts, and enhance affected person satisfaction. It signed on to be considered one of 5 healthcare methods in the ACE pilot.
In Case Study in Bundled Funds: The Baptist Health System Experience, Zucker outlines the San Antonio-based mostly 5-hospital system's motivation for participation, the important thing rules of the ACE demonstration, the challenges and advantages and success methods and classes discovered from the ACE demonstration — in addition to that 'Hallmark second' that generated buzz in the marketplace.
Zucker supplies a frank take a look at the challenges of structuring funds, adjusting for severity, partaking physicians and distributors, coordinating and negotiating providers and getting ready for transition to actual-life software.
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