From the VPMA: What’s the story with bundled payments?
03 Apr 2016By: Andrew Furman, MD, vice president of medical affairs
MACRA, MIPS, value-based purchasing, APMs, bundled payments. What’s it all mean? Here are links detailing these terms and how they can affect your practice and well-being.
- The Merit-Based Incentive Payment System (MIPS) & Alternative Payment Models (APMs) CMS
- MACRA: New Opportunities for Medicare Providers through Innovative Payment Systems, Health Affairs Blog
- Bundled Payments for Care Improvement Initiative (BPCI) Fact Sheet, CMS
- Hospital Value-Based Purchasing, CMS
- The Quadruple Aim: care, health, cost and meaning in work, BMJ Quality & Safety
The common theme is a change from the familiar fee-for-service to quality-based payment systems. Many providers are familiar with a system where seeing more, and doing more, means getting paid more. Because that model is not sustainable, the system is changing.
We can be angry. We can long for yesteryear. We can write parables describing how good things were, and add it to the story we tell our kids about walking to and from school in two feet of snow, uphill, both ways! However, we can’t stop the change. There may be tweaks here and there, but the train has left the station. We now practice in a world of increasingly complex methods of achieving and acquiring what was familiar to us in the past.
Know you are not alone in your confusion and frustration. The dialogue has started on many levels, and we can navigate through as a team hoping to achieve not just the triple aim (improving population health with increased patient quality and satisfaction at a lower cost), but the quadruple aim (adding joy to the experience of those providing care).