2nd Annual Summit on Bundled Payment

2nd Annual Summit on Bundled Payment
Held: January 25-26, 2017 in Atlanta, GA

The 2nd Annual Summit on Bundled Payment brings together executives from hospitals, physician groups, post-acute care, and health plans to enhance care coordination, create value-added partnerships, and engage physicians to achieve success with bundled payment strategies.

View Original Brochure Agenda (PDF)

11 available session presentation slide decks (PDFs) included with purchase.

Session Topics Include:

Chairperson’s Welcome and Opening Remarks
(1 min 46 sec)

Mary Beth Pace, RN, BSN, MBA, ACM, CMAC
Vice President, Care Management
Trinity Health

Prioritize Bundled Payment Models as a Key Strategic Issue for Providers and Payers
(32 min 25 sec)

Over a few short years, bundled payments have gone from a niche payment strategy to a key strategic issue for payers and providers. Medicare has forged the way with five bundled payment models, but commercial markets are starting to see movement as well. This care redesign strategy is bringing down costs and improving outcomes, not only in orthopedics but across many high priority clinical areas. In this session, explore the state of bundled payments and where the industry is going to ensure your organization is ready.

  • Understand the current Medicare models for bundled payment and the results they are having
  • Discuss the impact that increasing commercial engagement with bundled payments will have on the market
  • Examine the strategic issues payers and providers face in structuring a bundle

David Terry
Founder, Chief Executive Officer
Archway Health

Redesign Care to Succeed in Bundled Payment
(46 min 6 sec)

The success of the bundle, in large part, depends on the work that takes place before the patient hits the hospital. Hospitals must work with patients and their caregivers to educate them and prepare the home so they can be discharged from hospital to home sooner and with better results.

  • Develop tools to redesign care
  • Discuss next level improvements to improve care redesign protocols
  • Determine how to incorporate successes in care redesign into your bundled payment strategy
  • Evaluate how your care redesign impacts patients not involved in the bundle
  • Learn how to evaluate outcomes from care redesign as they relate to improving patient and provider satisfaction, quality measures, and cost reduction
  • Learn tactics to ensure physician and leadership engagement as critical components of care redesign

Deirdre Baggot, PhD, MBA, RN
Principal, Bundled Payments Practice
ECG Management Consultants
Former Lead, Acute Care Episode (ACE) Bundled Payments Pilots
Centers for Medicare & Medicaid Services (CMS)

Improve Bundled Payment Model Sustainability by Managing Unscheduled Care
(39 min)

Patients often require unscheduled or urgent care after discharge. This care frequently occurs in the emergency department and studies have shown a 15-23% ED visit rate for CJR-eligible patients within 90 days of discharge. In this population, over 40% of emergency department visits occurred in non-affiliated emergency departments. This session will explore different strategies to build an acute-care model that values appropriate emergency department care and interventions, and mitigates unnecessary visits that are preventable through better discharge planning, care coordination and patient education.

  • Understand which patients are most likely to present to the ED post-discharge to improve discharge planning
  • Identify quality improvement tools to make bundled payment models more sustainable through partnerships with ED groups
  • Discuss when it is appropriate for patients to utilize the ED to improve resource utilization and to avoid adverse outcomes

Susan Nedza, MD, MBA
Senior Vice President of Clinical Outcomes Management, MPA Healthcare Solutions
Former Chief Medical Officer at the Centers for Medicare and Medicaid Services (CMS)

Part 1 - Utilize Remote Patient Monitoring in Bundled Payment Models to Fill Gaps in the Care Continuum
(15 min 40 sec)

As value-based reimbursement models continue to grow, maintaining close communication with patients, secondary providers, and facilities is paramount to reducing cost of care through appropriate treatment and patient monitoring. When patients are moving throughout multiple facilities and receiving care from various providers, there can be points where care is disjointed, leaving patients without care when they need it. Through the use of telemedicine, providers can assist in consulting with secondary providers, monitor patient progress, and conduct remote follow-up visits. In this session, explore emerging technologies that improve access and patient care within the bundled payment reimbursement model.

  • Understand the cost and benefits to using telemedicine for bundled payment patients
  • Discuss the operational components of implementing a telemedicine program within a bundled payment model
  • Leverage technology to bend the cost curve while improving patient satisfaction and outcomes

Paul Bruning, DHA
Chief Operating Officer
Tallahassee Orthopedic Clinic

Lauren Faison
Service Line Administrator, Regional Development, Population Health, and Telemedicine
Tallahassee Memorial Healthcare

Part 2 - Empower Patients and Care Teams through Connected Devices and Smart Data
(15 min 25 sec)

How can using innovative technologies, like RPM, telemedicine and streamlined data from connected devices prevent information overload and allow you to provide better, more informed care? Studies show that managing chronic care in the U.S. with remote patient monitoring (RPM) could save nearly $200 billion across all conditions over the next 25 years.

  • Explore the value of connected care technologies such as RPM and telemedicine for bundled payment patients.
  • Identify unique ways to close the gap of care outside of the office, and engage more deeply and efficiently with your patients.
  • Increase patient engagement with smart data and actionable insights to help boost population performance.
  • Learn how to support value-oriented, proactive care without creating extra work.

Dr. Jerome Aya-Ay
Managing Member and Chief Executive Officer
Palmetto Proactive Healthcare

Justin Williams
Founder and Chief Executive Officer 

Chairperson’s Welcome and Review of Day One
(7 min 28 sec)

Christine Maroulis
Senior Director, U.S. Health Policy and Reimbursement
Johnson & Johnson Medical Device Companies

CASE STUDY: Examine Cardiac Bundled Payment Models and the New Cardiac Rehabilitation (CR) Incentive Payment Model
(1 hr 1 min 7 sec)

CMS recently announced a new mandatory bundle (Episode Payment Models: EPM) for cardiac cases (ACS and CABG) that also incentivizes cardiac rehab. Cardiac bundles pose both unique challenges and opportunities when compared to the more common orthopedic bundles, with this initiative now covering a complement of surgical, procedural, and medical interventions with strategic implications for non-cardiac service lines as well. In this case study, hear best practices from organizations who have achieved success with cardiac bundled payments and discuss the implications of the EPM initiative.

Part 1: Discuss the New Mandatory Bundle and Key Lessons Learned from Implementing a Cardiac Bundle

  • Review the CMS cardiac expansion (EPM)
  • Examine the cardiac rehab incentive and its impact on health outcomes
  • Overcome challenges with managing a bundle for polichronic individuals

Scott Campbell, EdD
Manager, Heart and Vascular Quality; Champion, PSF Heart Failure Bundled Payment Initiative, Chest Pain Center Coordinator
Penrose-St. Francis Health Services

Part 2: Drive Better Outcomes in the New Cardiac Bundles with Big Data, Predictive Analytics, and Simulation Technology

  • Develop a multi-layer approach to gain optimized results
  • Predict the optimal PAC pathway stops
  • Improve point of care informed discharge decision support
  • Understand patient discharge compliance levels to proactively design care programs and reduce readmissions

Satish Kodavali
Founder and Chief Executive Officer
iCube Medical Inc.

Vijay R. Marwaha, MD
Interventional Cardiologist
The Cardiovascular Centers

Engage Physicians and Align Incentives to Bring Episodes of Care Models to Scale
(49 min 8 sec)

Bundled payment models offer physicians an opportunity to be part of care redesign. These models are constructed locally but bringing them to scale across a system is no easy feat, particularly when operating across medical bundles. Physician engagement is critical to ensuring the success of a bundle with a value add clinically and financially. In this session, hear how Northwell Health has designed physician engagement to bring its bundled payment strategy to scale.

  • Identify physician champions to engage providers in care redesign
  • Develop strategies to incentivize providers
  • Discuss physician engagement on a local and regional scale to identify best practices to bring programs to scale

Zenobia Brown, MD
Medical Director, Advanced Illness Management & Bundled Payments
Northwell Health Solutions

Ensure Patient Engagement for Episode Payment Model Success
(21 min 57 sec)

In December 2016, the Centers for Medicare & Medicaid Services (CMS) finalized a ruling mandating episode payment models for surgical hip/femur fracture treatment (SHFFT). This is the second mandatory orthopaedic episode payment model, following the April 1, 2016 implementation of the Comprehensive Care for Joint Replacement (CJR) model. The success of these models is often predicated on engaged and motivated patients. Research has shown that prepared and engaged patients will be less likely to visit the emergency room after surgery and less likely to be readmitted to the hospital following discharge. In this session, explore strategies that aim to provide and realize value in bundled payment models.

  • Discover how health systems can partner with external stakeholders to address the Triple Aim in order to deliver value in bundled payments
  • Learn about specific patient activation principles to help engage patients before, during and after their orthopaedic surgery
  • Understand why bundled payment-centric solutions must encompass the entire care continuum to drive success – from admittance to discharge to post-acute rehabilitation

Christine Maroulis
Senior Director, U.S. Health Policy and Reimbursement
Johnson & Johnson Medical Device Companies

Translate Data to Make It Actionable In Real Time
(46 min 1 sec)

The right data is critical to enable organizations to evaluate cost variations and identify areas for improvement and make bundled payment programs financially feasible. In this session, discuss ways to develop strategies that ensure your decision making is driven by actionable data that yields effective results.

  • Understand what data to use and analyze to drive value-based care
  • Translate data to understand the variations in provider practices to improve protocols
  • Leverage predictive analytics to set goals, mitigate risks, and cut costs for health outcomes in the bundled payment model
  • Stratify care management in real time to inform care redesign and clinical decisions

Michael Cousins, MS, PhD
President and Chief Analytics Officer
Forecast Health

Leverage Patient Reported Outcomes to Improve Quality and Manage Risk
(44 min 22 sec)

Patient Reported Outcomes (PROs) are becoming increasingly more important as CMS issues financial and regulator incentives for collecting these measures in its bundled payment models. Through PROs, providers can gain a better understanding of the quality measures that matter to their patients as well a better understand their patients’ comorbidities to develop better risk stratification. In this session, explore how the Function and Outcomes Research for Comparative Effectiveness (FORCE) TJR program collects PROs and the impact it has on their care redesign.

  • Learn how to use PRO to set goals with the patients, monitor progress in real time, and adjust treatment plans to support patients in achieving their goals
  • Examine the importance of collecting PRO to improve quality and outcomes in a bundled payment program
  • Leverage PRO to understand patient comorbidities, predict what the patient episode will look like, and take a proactive approach to minimize risks

David Ayers, MD
Chair, Orthopedics
UMassMemorial Medical Center

Paul A. Lofrumento

Senior Director, MSK Center of Excellence
UMassMemorial Medical Center

Case Study: Uncover Lessons Learned from BPCI and CJR Participation to Improve Quality of Care
(43 min 49 sec)

Through the BPCI program, organizations have been able to pilot bundled payment programs and voluntarily take on risk. Now, with CMS mandated bundles under CJR and the proposed rule for cardiac bundles, bundled payments are becoming a key strategy in the shift to value-based reimbursement. By examining the experiences of those who participated in BPCI and CJR, organizations can better prepare to design their own bundled payment strategy. In this case study, learn from one organization about its experience with BPCI and CJR and how its strategy has evolved from conception to now.

  • Discuss the tools and resources necessary to implement a bundle
  • Design steering committees to engage staff across the continuum of care
  • Hear how designing a patient education program for joint replacement had improved HCAHPS scores
  • Learn from the anticipated and unanticipated challenges faced in program design and implementation
  • Examine successful strategies for coordinating with care teams and SNFs to reduce length of stay

Michael A. Kelly, M.D.
Chairman, Department of Orthopaedic Surgery
Hackensack University Medical Center
Clinical Professor, Orthopaedic Surgery
Rutgers University Medical School
Director, Insall Scott Kelly Institute for Orthopaedics

Explore the Challenges and Opportunities for Post-Acute Care Organizations Managing Bundled Payment Programs
(46 min 21 sec)

Bundled Payment participation is growing across the continuum of care. As mandatory bundles expand, SNFs need to be prepared to manage bundled patients after their discharge from the hospital. In this session, discuss the challenges post-acute care organizations experience in managing a bundle to develop strategies that improve quality of care and reduce costs.

  • Examine the components of care redesign to improve quality of care
  • Address strategies to manage utilization
  • Hear how to overcome challenges in getting the right DRG for patients in the bundled payment program
  • Learn how to improve patient compliance
  • Understand how to improve care coordination across the episode of care

John A. Capasso
Executive Vice President, Continuing Care
Trinity Health (formerly CHE Trinity)

Closing Keynote: Achieve Better Outcomes through Increased Collaboration between Providers and Plans
(33 min 43 sec)

Health care providers and health plans have the same goal of improving care of populations, but they are not integrated in their efforts. This can lead to duplication of services or multiple touch points through different care management programs, increasing health care costs and confusing the health care consumer.

  • Build technology that overlays clinical workflow and processes to facilitate physician awareness of existing gaps in care
  • Explore the common themes and objectives of the Medicare Advantage and ACO models
  • Build programs to incentivize physicians around care plans rather than risk

Ankit Patel
Vice President, Provider Alignment
Clover Health