What’s In A HealthCare Payments Bundle?

The Bundling and Coordinating Post-Acute Care (BACPAC) Act of 2014 (HR 4673) was introduced this week, and is designed to establish bundled payments for post-acute care services covered by Medicare. What does it mean for the health care payments business?

Earlier this week, representatives David McKinley (WV-1) and Tom Price (GA-6) introduced the BACPAC Act, which establishes a site-neutral bundled payment model for Medicare post-acute care (PAC). According to a press release from the Partnership for Quality Home Healthcare, the proposed payment structure would have PAC coordinators and their networks of post-acute care providers manage patient care through a 90-day, site-neutral bundled payment that would be initiated upon a patient’s discharge from the hospital.

CEO for The Partnership for Quality Home Healthcare, Eric Berger, said in the company statement that the proposed legislation offers “pro-patient solutions” that are founded on years of research and analyses. Additionally, those solutions support a more effective and efficient delivery of quality post-acute care services.

“As our population ages, the need for well managed post-acute care will become a pressing necessity for the sustainability of our healthcare system,” Berger explained in the statement. “The BACPAC Act of 2014 represents positive Medicare reform that benefits patients, providers and taxpayer alike.”

One of the major changes that the bill hopes to make is to reduce hospital readmissions. As the Partnership for Quality Home Healthcare explained, readmissions are a common cost-driver in PAC. However, the proposed legislation creates strong incentive for patients to be placed in the most “clinically-appropriate, cost-effective setting.” From there, it is more likely that patients would receive more efficient care through their treatment plan.

The bill stemmed from the BACPAC analysis that was proposed by the Alliance for Home Health Quality and Innovation in January. The analysis was compiled by Compiled by Dobson | DaVanzo & Associates, and explained the benefits of bundled payment options for post-acute care, as well as how providers can control costs.

According to Allen Dobson, Ph.D. and president of Dobson, if implemented correctly, bundling payments for chronic care management, rehabilitative and other forms of post-acute care could lead to more efficiency across care settings and encourage care coordination among providers.

“In the current fee-for-service system, care coordination is often overlooked, resulting in unnecessary tests, procedures   and costs to the Medicare program that often do not improve patient care or outcomes,” Dobson said in an Alliance for Home Health Quality and Innovation statement.

In that same release, research from the Clinically Appropriate and Cost-Effective Placement (CACEP) Project was cited, which explained that Medicare could see up to $100 billion in savings over 10 years by moving patients into different settings and reducing spending by certain degrees.