Curbing Healthcare Costs Through Bundled Payments

An article by Archway Health Founder & CEO Dave Terry titled “Curbing Healthcare Costs Through Bundled Payments” was recently published on the Healthcare Financial Management Association (HFMA) blog. "With a new president and Republican-led congress, a dramatic change to the healthcare landscape is imminent. Whether the Affordable Care Act is repealed entirely or drastically reshaped, the reality is that the cost of health care is a real issue that must be addressed," Dave says.

He says that a basic problem with many current health plan solutions is that they generally combine primary care access, true insurance, and specialty care access into a single complex product. This approach does not meet the unique needs of many people who would be better served with a more customized health care approach that is possible when these three elements are handled individually. Bundled payments provide a way to lower costs and improve quality of care for specialty services.

At the conclusion of the article, Dave recommends several steps forward for healthcare administrators and executives:

  • Follow Medicare’s lead and increase the adoption of specialty bundled payment programs into the commercial health insurance market.
  • Expand the number of specialists and health systems that can participate in a bundled payment contract.
  • Work collaboratively to introduce innovations in coverage.
  • Empower patients to make informed decisions.
  • Conduct a bundled payment readiness assessment.

Read the full article here:

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Smart Strategy, IT Consultants Preparing Their MACRA Pitches

Archway Health CEO Dave Terry is quoted in an article recently published in Value-Based Payment News, a monthly newsletter for professionals in healthcare. The article, titled "Smart Strategy, IT Consultants Preparing Their MACRA Pitches," discusses some of the opportunities that will be available for information technology providers and strategic consultants under the Medicare Access and CHIP Reauthorization Act (MACRA). “In order to succeed, these physicians will need help building and managing effective bundled payment programs and other types of care and risk management initiatives,” Dave says, as part of his summary of how physicians and specialists can prepare to participate in the program.

Read the full article here:

The Physician as the Provider at Risk: Rolling the Dice

YARTH_v31_i5_COVER.inddCheck out this article that was published in the Journal of Arthroplasty in May.  Archway Health and Carelink are key parts of the article and the article was approved by CMS. The article discusses the need for innovation and leadership in health care as bundled payment models become more common. In the study described in the article, Archway Health engaged 16 different PGPs to apply to become episode initiators in BPCI. Not all of the groups decided to proceed, but among the providers that elected to proceed, the results were impressive. For one of the PGPs, for example, there was a 70% reduction in SNF days per major joint episode over the first two performance quarters. Provider compliance was greater than 85% using the INACT process, and the 30-day readmission rate was reduced from over 7% to less than 2%. Also, this PGP showed 9-17% reconciliation savings.

Read the full article here: The Physician as the Provider at Risk