How to manage Orthopedic Bundled Payments?

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How to manage Orthopedic Bundled Payments?
In a bundled payments model providers and/or
healthcare organizations receive a single payment
for all the services delivered during an episode
of care. When it comes to orthopedics, bundled
payments are becoming more sophisticated and
standardized with the help of analytic insights
based on collected data from the surgeons. CMS
has made numerous changes to the Bundled Payments
for Care Improvement Advanced program for
2021 that will have a significant impact on
participants where these participants are no
longer able to select individual episode types,
such as lower extremity, upper extremity, or
spinal fusion.   Orthopedic bundled payments are
rising due to various benefits such as lower
cost, structure, specialist engagement, improved
quality, and attainment of organizational goals.
Moreover, Orthopedics is the most important
service line for most hospitals, and joints are
the mainstream of revenue generation for
healthcare providers. Various lucrative benefits
attracted physicians to participate in bundled
payments program however, you should know its
management to avoid various challenges like
withhold care from those who require more
resources than the bundle allows, such as those
from a lower socioeconomic status.
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How to manage Orthopedic Bundled Payments?
Following suggests recommendations can be helpful
to you to manage Orthopedic Bundled
Payments   Identify opportunities to reduce
patients risk before surgery The hospital
estimated financial risk for complications and
mainly for those that lead to increased
post-acute charges under bundled payments.
Orthopedic surgeons should direct preoperatively
risk assessment tools to identify opportunities
to reduce patients risk before surgery by
helping patients control their diabetes or by
treating pre-existing Staphylococcus aureus
colonization. Build robust data system Even
after months of service delivery, the federal
government reconciles episode costs and payments
retrospectively hence providers must carefully
track utilization and expenses in real-time to
manage an episode of care. A robust data system
enables hospitals to respond proactively to
issues that could lead to a poor outcome and/or
increase costs.
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How to manage Orthopedic Bundled Payments?
The established data systems can help to capture
the cost of all aspects of care, including
pre-admission testing, implants, or any other
materials used during the procedure, the
inpatient stay, services provided during the 90
days after the hospital stay, and any stakeholder
payments. Optimizing care episodes You can
optimize care episodes with the help of cost and
outcome variations across an institution as
variation analysis can identify and reduce
unnecessary waste. Data often show no correlation
between high costs and superior patient outcomes
and providers who are outliers in terms of
episode costs can often be persuaded to adopt
more efficient practice patterns. Both efforts
help to control costs which is an important
discipline under bundled payments. Ensure
quality measures Cost control is an important
discipline of bundled payments. However, quality
measures are also an essential component of these
programs. Three principal quality measures from
CMS are the hospital-level risk-standardized
complication rate, Hospital Consumer Assessment
of Healthcare Providers and Systems (HCAHPS)
survey results, and patient-reported outcomes.
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How to manage Orthopedic Bundled Payments?
Hence to perform well under bundled payments,
hospitals must work to optimize care quality and
patient outcomes. Stakeholder management If you
want to be successful in orthopedic bundled
payments then you need careful management of
various stakeholders like physicians, nurses,
ancillary staff, and post-acute providers. The
alignment of various stakeholders must be the
primary objective of Hospital administrators and
orthopedic leaders to achieve the mission and
goals of the bundled payment program. Moreover,
interdisciplinary leadership teams are organizing
clinical units which help to offer coordinated
services across the episode of care. Finally,
you need to understand that CMS has been clear
that bundles are here to stay, and CMS has
already signaled for a much broader and
all-encompassing mandatory bundled payment
program. Hence management of these bundled
payments is also crucial. Are you looking for
billing partners? You can easily pick us. Our all
processes are HIPAA compliant, and all our
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