The Healthcare Financial Management Association (HFMA) recently posted an article written by Archway Health's CEO, Dave Terry, titled "CMMI's 'New Direction' Points to the Future of Bundled Payments." The article discusses the future of value based care and what payment models providers will be able to leverage. He explains that, "With CMS steering the healthcare industry in a new, physician-led direction, providers can stay ahead of payment reform with bundled payment programs. The changes happening at CMS should be heartening to physicians as they will be championed as leaders in the continued shift from fee-to-service to value-based care." Read the full article from HFMA here.
Although CMS recently announced many changes to current mandatory bundled payment models, industry groups believe that the government will continue to shift the U.S. health care system away from fee-for-service care models and push it towards value-based care. Providers expect that the Trump administration will "take a more conservative approach to bundled payments, with a focus on voluntary participation and fewer regulations."
Morning Consult interviewed Archway Health's GM of BPCI, Keely Macmillan, on her thoughts of the recent CMS announcements. She said CMS “wanted to clear the way for them to test more voluntary initiatives and that allowed them to have more flexibility in testing new innovations,” and “by pulling back those hospital mandatory programs, they can launch other physician-driven alternative payment models that are voluntary and more inclusive of a broader provider audience.”
Read the full article here
Last week, Archway Health CEO, Dave Terry, and GM of BPCI, Keely Macmillan, were featured in an article by McKnight's discussing recent CMS announcements.
On November 30th, 2017 CMS confirmed the cancellation of mandatory bundled payment models for hip fractures and cardiac care, as well as modifications to the Comprehensive Care for Joint Replacement Model. CMS Administrator Seema Verma said, “While CMS continues to believe that bundled payment models offer opportunities to improve quality and care coordination while lowering spending, we believe that focusing on developing different bundled payment models and engaging more providers is the best way to drive health system change while minimizing burden and maintaining access to care.”
Archway's Keely Macmillan believes that the announcement is “great news for nursing home providers,” and that this, “really clears the way for SNFs to be engaged in these voluntary programs.”
At Archway Health, we believe that the cancellations of mandatory models pave the way for voluntary success by giving engaged providers the opportunity to innovate around the best way to care for their patients across the full continuum of care.
Read the full article by McKnight's here.
Last week, Archway Health's CEO, Dave Terry, and GM of BPCI, Keely Macmillan, were interviewed by HealthExec on their predictions of where this 'new direction' will take CMMI. "I do think this new administration, whether they might have a different approach or just a different name, they do genuinely want to get rid of waste in the system and reduce unnecessary federal spending," Macmillan said. "Regardless of who you are, I think the need to reduce excess spending by Medicare and redirect those funds is universally recognized." CEO Dave Terry correctly predicted that the new leadership would change the participation of the program from mandatory to voluntary, and he believes that this transition paves the way for voluntary success. Terry said, "What we saw with the mandatory models is not very high engagement from the participating hospitals and really watered-down rules to make it palatable. It just really didn’t move the needle on improvements. The voluntary ones, you see tremendous engagement from the physicians and providers, you see them moving the needle quickly and effectively, and that starts to change markets. You don’t need that many participants to wake up the competition and start moving towards improvement. We actually think the voluntary ones will change and shape markets faster than the watered-down mandatory ones."
Read the full Q&A here.
Archway Health CEO Dave Terry was recently quoted in McKnight's article titled "CMS surprises-and doesn't- with pay model changes" on the elimination of previously mandatory payment models. “We thought [the models] would probably be switched from mandatory to voluntary,” he said. “But we didn't think they would be eliminated, just because there is demand for these programs on the voluntary side.” Although the complete elimination of the program was a surprise to many, experts predicted a shift from mandatory participation to voluntary. As we previously highlighted in this blog post, our team at Archway believes that this news is promising for the future of voluntary programs.
In the article "Voluntary participation in bundled payments will continue after CMS cancels mandatory initiatives, experts say," Healthcare Finance interviews experts for their thoughts on the recent news of the proposed rule by CMS to cancel the episode payment models and the cardiac rehabilitation incentive payment model. Experts interviewed by Healthcare Finance, including Archway Health CEO Dave Terry, "believe the switch from mandatory to voluntary bundles is positive for providers and will not affect participation or the movement to value-based care."
Eliminating the mandatory models gives CMS greater flexibility to design and test innovations that will improve quality and care coordination across the inpatient and post-acute-care spectrum, the agency said in the proposed rule.
As part of their reporting on the new proposed rule released by CMS on Tuesday, McKnight's interviewed healthcare experts to learn their insights into the proposal. In an article titled "CMS proposes cancelling cardiac, orthopedic bundled payment models," Archway CEO Dave Terry tells McKnight's that some changes to the programs had been expected in light of Department of Health and Human Services Secretary Tom Price's support of voluntary bundled payment programs instead than mandatory programs. Dave says:
“We thought [the models] would probably be switched from mandatory to voluntary … but we didn't think it would be eliminated, just because there is demand for these programs on the voluntary side.”
Some experts, including Dave, have said that there is a possibility that CMS may make the models voluntary rather than canceling them entirely:
CMS may also roll it into the upcoming BPCI Advanced initiative, which Terry believes will still “move full speed ahead.”
Read the full article from McKnight's here.
A new brief in Healthcare Dive covers news of a proposed rule released by CMS that reduces areas that are required to participate in the mandatory joint bundled payment program and cancels the cardiac bundled payment model. Healthcare Dive concludes the article by quoting Archway CEO Dave Terry's statement that bundled payment models are likely to endure.
Bundled payments are positive for providers and aligns their interests with those of payers and patients, he said.
“In this scenario, acute care will ultimately constitute a smaller component than currently, so hospital payments could well shrink," he said. "However, if hospitals take the appropriate action they can sustain and even grow their bottom lines by more coordinated and prudent use of resources.”
Read the full brief from Healthcare Dive here.
Dave Terry, founder and CEO of Archway Health, is quoted several times throughout a new feature published today on Healthcare Dive. The article by Les Masterson is titled "Despite federal delays, bundled payments will be entrenched in US healthcare." Dave tells Healthcare Dive that CMS has shown that they remain committed to bundled payments. This message has been consistent both pre-election and post-election.
Dave also says that though the changes involved in implementing a bundled payment program may feel overwhelming, bundled payment programs ultimately lead to more autonomy and funding to manage patient populations.
"In this scenario, acute care will ultimately constitute a smaller component than currently, so hospital payments could well shrink. However, if hospitals take the appropriate action they can sustain and even grow their bottom lines by more coordinated and prudent use of resources."
The article also mentions the BPCI Advanced program:
There is another bundled payment announcement expected this summer — the next iteration of the BPCI program. No matter when CMS announces its next bundled payment program, Terry said CMS will continue bundled payments — regardless of the delays and the HHS secretary's opposition to mandatory programs.
“There will likely be more delays, but everything we’ve heard and everyone expects in the industry is that it’s coming,” said Terry.
Read the full article here.
In an article in Healthcare Finance titled "Expert: Trump administration 'buying time' by delaying bundled payment programs," Healthcare Finance associate editor Jeff Lagasse talks to Archway Health CEO Dave Terry about what the recent delays announced by CMS mean for bundled payment programs. "It appears to me that they're just kind of buying time," Dave says. "Obviously there's a lot going on right now with CMS, with the healthcare reform bill and the new head of CMS being appointed within the past couple of weeks. I think they're giving themselves some more time."
From Healthcare Finance: "But Terry said it appears the administration, and the healthcare industry, are likely moving full-speed ahead on the shift from volume to value, with bundled payments representing a significant aspect of that sea change."
What may change however, according to Dave, is that some bundled payment programs may become voluntary instead of mandatory, and this could be a good thing. "We actually think the voluntary programs are a much better option for driving change than mandatory programs," Dave says. "When physicians sign up for voluntary programs, they're incredibly engaged in reducing costs. When you voluntarily sign up for something, the C-Suite is engaged, and change can happen much more swiftly and much more rapidly."
Read the full article here: Expert: Trump administration 'buying time' by delaying bundled payment programs
The Healthcare Financial Management Association (HFMA) also quoted Dave Terry in their reporting on the CMS delay.
From HFMA: "However, Terry said he has seen a lack of widespread 'engagement' by hospitals in CJR and the EPM programs because most don’t have the volume in those procedures for the models to have much of a financial impact. He blamed the lack of hospital focus on 'watered down' rules, including the lack of penalties in their first years and front-loading bonus payments for the small share of hospitals that have large volumes affected by the programs."
"'Some of them got engaged early, but many of them are waiting for the risk until it hits their radar screen as the top five or 10 things that they are worried about,' Terry said."
Read the full article here: Does Bundle Delay Signal the End of Mandatory Models?
Got a question about bundled payments? Ask us now.
Modern Healthcare recently published an article titled "CMS delays expansion of bundled payment programs." In the article, writer Elizabeth Whitman reports on the interim final rule published by CMS on the delay. The rule states: "This additional three-month delay is necessary to allow time for additional review, to ensure that the agency has adequate time to undertake notice and comment rulemaking to modify the policy if modifications are warranted, and to ensure that in such a case participants have a clear understanding of the governing rules and are not required to take needless compliance steps." The article includes Archway Health CEO and Co-Founder Dave Terry's comments on how providers are preparing: "Out of about 1,200 providers slated to be included in mandatory cardiac episode payment models, or EPMs, about 10% had expressed interest in actively preparing for them, said Dave Terry, CEO of Archway, a company that works with providers on bundled payment initiatives. Providers in the voluntary space were much more engaged, he said."
The article concludes: "One area of consensus is that this interim final rule on mandatory payment reforms is not the last the CMS will issue. Whether the agency will delay them again, before October, or transition them into a voluntary model, 'I'll be surprised if this is the final change,' Terry said."
Cardiovascular Business also quotes Dave Terry in their coverage of the CMS delay this week: "Archway Health CEO Dave Terry said in an interview with HealthExec in January that he anticipated the programs would continue as voluntary initiatives."
Read the full Modern Healthcare article here: http://www.modernhealthcare.com/article/20170320/NEWS/170329991
Read the full Cardiovascular Business article here: http://www.cardiovascularbusiness.com/topics/healthcare-economics/cms-delays-cardiac-bundled-payments-models-three-months
Got a question about bundled payments? Ask us now.
Archway Health Founder & CEO Dave Terry is quoted in an article titled "Industry Nervously Watching for 2018 Voluntary CMS Bundles” that was recently published on the Healthcare Financial Management Association (HFMA) blog. The article by Rich Daly discusses CMS leadership challenges, the payment models that analysts expect may be launched in 2018, and the interest in bundled payment models shown by private payers. “The fact that CMS is showing results and continues to move it forward is indicating to the market that it is real,” Dave said. “They wouldn’t push it forward if they weren’t seeing some success.”
Read the full article here: http://www.hfma.org/Content.aspx?id=53123
Got a question about bundled payments? Ask us now.
Archway Health CEO and Founder Dave Terry recently spoke to Health Exec on the state of bundled payments in 2017. His responses were published in a Q&A, where Dave explains to Health Exec writer John Gregory "how the policies of President-elect Donald Trump and his pick to run HHS, U.S. Rep. Tom Price, MD, R-Georgia, could benefit value-based care initiatives and bundled payments in both Medicare and commercial insurance." Read the full article here.