Related Related Related acute care readmissions readmissions services Other services Related defined in the readmissions bundle services defined in the bundle Expected To be proposed To be proposed To be proposed To be proposed Discount by applicant; CMS by applicant; CMS by applicant by applicant; Provided to requires minimum requires minimum subject to Medicare discounts discount of 3% for minimum discount increasing from 30-89 days of 3%; larger 0% in 6 mos. discount for to 2% in Year 3 episode; 2% for in ACE 90 days or longer Demonstration episode Payment Acute care Traditional Traditional Prospectively from CMS to hospital: IPPS payment payment established Providers payment less to all providers to all providers bundled payment and suppliers, and suppliers, to admitting discount subject to subject to hospital; hospitals reconciliation with reconciliation with distribute predetermined predetermined payments from Physician: target price target price bundled payment Traditional fee schedule payment (not included in episode or subject to discount) Quality All Hospital IQR To be proposed by applicants, but CMS will ultimately Measures measures and establish a standardized set of measures that will be aligned additional to the greatest extent possible with measures in other CMS measures to be programs proposed by applicants Appendix 2 Details of 2 Model 2: Retrospective Bundled Payment Models For Hospitals, Physicians, And Providers For An Episode Of Care Consisting Of An Inpatient Hospital Stay Followed By Care , August 29, 2011
Related care services Related readmissions services defined in the bundle Related readmissions Other services defined in the bundle Related readmissions Expected Discount Provided to Medicare To be proposed by applicant; CMS requires minimum discounts increasing from 0% in 6 mos. to 2% in Year 3 To be proposed by applicant; CMS requires minimum discount of 3% for 30-89 days episode; 2% for 90 days or longer episode To be proposed by applicant To be proposed by applicant; subject to minimum discount of 3%; larger discount for in ACE Demonstration Payment from CMS to Providers Acute care hospital: IPPS payment less discount Physician: Traditional fee schedule payment (not included in episode or subject to discount) Traditional payment to all providers and suppliers, subject to reconciliation with predetermined target price Traditional payment to all providers and suppliers, subject to reconciliation with predetermined target price Prospectively established bundled payment to admitting hospital; hospitals distribute payments from bundled payment Quality Measures All Hospital IQR measures and additional measures to be proposed by applicants To be proposed by applicants, but CMS will ultimately establish a standardized set of measures that will be aligned to the greatest extent possible with measures in other CMS programs Appendix 2 Details of 2 Model 2: Retrospective Bundled Payment Models For Hospitals, Physicians, And Providers For An Episode Of Care Consisting Of An Inpatient Hospital Stay Followed By Care , August 29, 2011 acute
AHCA_201110_CMMIBundledPaymentInitiative_OverviewAndMemberSupport_FINAL_20111010.docx