How to Hit a Home Run with Bundled Payments.
As health care payment reform continues to evolve, reimbursement increasingly is being linked to outcomes as well as to expenditures. Toward this end, the Centers for Medicare & Medicaid Services has established models for "bundled" payments to long-term care providers, using predetermined payments based on historical spending rates, in a new pay-for-performance landscape. The goal is to reward providers for quality and cost-effective care as well as penalize them for adverse patient outcomes and hospital readmissions based on the target spending rates. Pharmacists have a role in these new models of care, but need to broaden their partnerships and relationships with providers and be prepared to prove they are contributing both to quality care and to reducing costs.
Harrisburg, Pennsylvania, USA.
Joanne
J
Kaldy
D014487:Centers for Medicare and Medicaid Services, U.S. / Q000191:economics; D003362:Cost-Benefit Analysis; D005102:Health Expenditures; D006801:Humans; D008134:Long-Term Care / Q000191:economics* / Q000458:organization & administration / Q000592:standards; D017146:Models, Organizational; D010593:Pharmaceutical Services / Q000191:economics / Q000458:organization & administration; D010595:Pharmacists / Q000191:economics / Q000458:organization & administration*; D024382:Professional Role; D011787:Quality of Health Care; D012051:Reimbursement Mechanisms / Q000191:economics*; D012052:Reimbursement, Incentive / Q000191:economics*; D014481:United States