Health Management

Payment Innovation

The year 2013 marked the beginning of the Centers for Medicare and Medicaid Services initiative described as Bundled Payment for Care Improvement (BPCI). BPCI is one of several Medicare alternative payment models (APMs) — like accountable care organizations and the patient-centered medical home — that have been developed to preserve or improve quality of care, while reducing the total cost of care.

Since then, 25 Dignity Health hospitals and one affiliated hospital have enrolled in the program, covering 46 unique episodes of care and more than 27,000 Medicare patients.

The BPCI program promotes value-based care and operational efficiencies, while providing facilities and providers the opportunity to share in savings achieved by a more coordinated approach to care.

Dignity Health partners with naviHealth, a post-acute care services company that helps us to manage patients in the post-acute facilities environment. The collaborative efforts among hospitals, providers, post-acute facilities and naviHealth have yielded better outcomes and improved efficiency, which work in tandem to create more value-based care.

These results translate to savings for patients, the participating hospitals and naviHealth. Through Q2 2017 (the most recent quarter with fully reconciled data), Dignity Health achieved savings of $33 million. Additionally, we are projecting $53 million in savings through Q1 2018.

BPCI Savings Summary

Utilization Summary – LTCH & IRF

Utilization Summary – SNF 1st PAC & LOS

Based on February 2018 monthly CMS claims filed for the BPCI bundled payment program.

The collaborative efforts among hospitals, providers, post-acute facilities, and naviHealth (post-acute services partner) have yielded both operational improvements and financial savings, which work in tandem to improve patient outcomes. This has resulted in reduction in long-term care hospital (LTCH), inpatient rehab facility (IRF), and skilled-nursing facility (SNF) discharge and length of stay (LOS), shown above, paired with a stable risk-adjusted readmission rate.