AHCA Official Receives Total Consciousness…



Washington, D.C.—Good morning, ProviderNation. The questions on all minds, of course, are, What did James Michel know, and when did he know it?

You’ll recall that Michel was one of the stars of last week’s Provider IGNITE panel (hat tip, again, to the fine folks at PharMerica for sponsoring). He told (warned?) the audience that the proposed rules to bundled payments for knee-and-hip surgery were merely the tip of the spear.

“It’s important because it sets a precedent by moving from a voluntary, demonstration style of alternative payments to a mandatory alternative payment,” he said. More than that, the fine folks at CMS had already done 130 alternative payment demonstrations, and he expected more such rules to come flying out of Washington over the next 16 months as the Obama administration attempts to “lock in” its health care reform legacy.

Faster than you can say “Nostradamus,” CMS has announced that some 2,100 acute care hospitals, skilled nursing centers, doctors’ practices, and other assorted provider types are now moving out of prep and into the “risk-bearing” section of the “Bundled Payments for Care Improvement” initiative.

“By focusing on outcomes for an episode of care, rather than separate procedures in care delivery,” CMS’ own Patrick Conway says in a statement, “we are incentivizing hospitals, doctors, and other providers to work together to provide high-quality, coordinated care for patients.”

So Michel seems to have received total consciousness, well before his deathbed, which is nice. But he ought to be careful: He keeps this up, and they’ll make him a senior director of Medicare reimbursement and policy at some health care organization or something.

Florida Makes Its Move

Meanwhile, the Sunshine State has announced what it’s calling the “Dementia Care and Cure Initiative.” The fine folks at the Florida Department of Elder Affairs (talk about your Sophisticated Policy Apparatus) say they want to “partner” with folks to “increase awareness of dementia, as well as the services and supports currently available; assist communities with becoming more dementia-friendly; and advocate for programs that provide care and promote research efforts toward a cure. Action-oriented work plans will be individualized for communities as they work for the designation of a Caring Community.”

Florida has the country’s second-highest population of people who suffer from dementia, so any help is good help.

Care Versus Cure

Speaking of caring and curing, that study we mentioned a while ago has finally posted. Read it, and weep.

Bill Myers is Provider’s senior editor. Email him at wmyers@providermagazine.com. Follow him on Twitter, @ProviderMyers.

1 Comment

Filed under Long term care, Post-acute care

One response to “AHCA Official Receives Total Consciousness…

  1. Joshua Jacobs

    The conclusion of this article, that James Michel successfully predicted the move of 2,100 healthcare facilities to mandatory bundled payments, is misleading.

    The 2,100 are all voluntary participants in the Bundled Payments for Care Improvement (BPCI) initiative. They moved, voluntarily, into the risk-bearing phase (Phase 2) of the program – a choice the providers themselves made a number of months ago but was only made public via the CMS website this week.

    So, the 2,100 Phase 2 BPCI demonstration participants have no connection with the proposed rules for hip and knee bundling, and don’t really indicate a move from demonstration to mandatory type CMS policies. While it may be true that in the future bundles will become mandatory for providers, the 2,100 aren’t current evidence of it.

    I write this, of course, solely on behalf of the honor of Nostradamus.

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