Bundled Payments for Care Improvement: Preparing for the Medical Diagnosis-Related Groups

The Journal of Nursing Administration
Lauran HardinElizabeth Murphy

Abstract

The Centers for Medicare and Medicaid Services Innovation Center introduced the Bundled Payments for Care Improvement (BPCI) initiative in 2011 as 1 strategy to encourage healthcare organizations and clinicians to improve healthcare delivery for patients, both when they are in the hospital and after they are discharged. Mercy Health Saint Mary's, a large urban academic medical center, engaged in BPCI primarily with a group of medical diagnosis-related groups (DRGs). In this article, we describe our experience creating a system of response for the diverse people and diagnoses that fall into the medical DRG bundles and specifically identify organizational factors for enabling successful implementation of bundled payments. Our experience suggests that interprofessional collaboration enabled program success. Although still in its early phases, observations from our program's strategies and tactics may provide potential insights for organizations considering engagement in the BPCI initiative.

References

Mar 18, 2011·The New England Journal of Medicine·Jeroen N Struijs, Caroline A Baan
Jan 1, 2016·JAMA : the Journal of the American Medical Association·Matthew J PressPatrick H Conway
Jan 19, 2016·Journal of the American Medical Directors Association·Joseph G OuslanderDavid Newman
Feb 18, 2016·Academic Medicine : Journal of the Association of American Medical Colleges·Coleen KivlahanDarrell G Kirch
Feb 18, 2017·The Western Journal of Emergency Medicine·Lauran HardinMichael Olgren

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Citations

Feb 26, 2019·Journal of the American Geriatrics Society·Karen E Joynt MaddoxArnold M Epstein
Jul 1, 2020·The Bone & Joint Journal·Azeem T MalikThomas J Scharschmidt
Feb 6, 2020·The Journal of the American Academy of Orthopaedic Surgeons·Azeem Tariq MalikThomas J Scharschmidt
Dec 12, 2020·Diseases of the Colon and Rectum·Rocco RicciardiPatricia L Roberts
Nov 19, 2020·Computational and Mathematical Methods in Medicine·Xiaowei Sun, Yi Zhu
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