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Bundled Payments for Care Improvement: Preparing for the Medical Diagnosis-Related Groups
Lauran Hardin1, Adam Kilian, Elizabeth Murphy
1Author Affiliations: Director, Complex Care, Trinity-Health Michigan d/b/a Mercy Health Saint Mary's, Grand Rapids, and Senior Director, Cross-Continuum Transformation, National Center for Complex Health and Social Needs, Camden, New Jersey (Ms Hardin); Clinical Research Physician, Trinity-Health Michigan d/b/a Mercy Health Saint Mary's, Grand Rapids, and Clinical Research Physician University of Utah Health Care, Salt Lake City (Dr Kilian); and Chief Nursing Officer (Ms Murphy), Trinity-Health Michigan d/b/a Mercy Health Saint Mary's, Grand Rapids.
Background:
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).
Objectives:
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.
Results:
Our experience suggests that interprofessional collaboration enabled program success.
Conclusions:
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.
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