Collaborative members participating in both the Comprehensive Joint Replacement model and the Oncology Care Model outperformed peers by ~30% in performance year 2
CHARLOTTE, N.C. — Hospitals and physician practice members of the Premier Inc. Bundled Payment Collaborative are significantly outperforming their peers in achieving reconciliation and performance-based Medicare payments.
Approximately 86 percent of Premier Bundled Payment Collaborative members that participate in the Centers for Medicare & Medicaid Services (CMS) Comprehensive Joint Replacement (CJR) model achieved savings payments in performance year 2 of the program. Compared to 66 percent of all participants achieving savings payments nationally, Premier members consistently outperformed their peers by 32 percent – just as they did in the program’s first performance year. Additionally, the number of Premier Collaborative members that achieved savings to Medicare increased from 71 percent in performance year 1 to 95 percent in performance year 2 of the program. These cost savings were achieved while maintaining or improving quality, as Premier members outperformed their peers by 25 percent in achieving “excellent” quality scores.
Moreover, 66 percent of the physician practice members in Premier’s Collaborative earned performance-based payments in periods 1 and 2 of the CMS Oncology Care Model (OCM), outperforming peers by 100 percent and 27 percent, respectively.
“With millions of dollars in cost savings, these programs are significantly reducing healthcare spending for the federal government, while generating a new source of revenue for participants,” said Mark Hiller, Vice President of Premier’s Bundled Payment Collaborative. “Healthcare providers that have a clear strategy for transitioning to risk-based payment models are not only seeing positive results today, but they are also building the capabilities and partnerships needed for future economic and competitive viability. We are incredibly impressed by the successes our members are achieving in these programs, and applaud them for continuing to lead healthcare improvement and transformation across the industry.”
Premier members in both models report that access to timely and accurate actionable data, and networking with like organizations were the two most impactful success factors. These services are delivered to members of the Bundled Payment Collaborative, which has developed a one-to-many, cost-effective framework for bundled payments to ensure providers receive the largest possible share of savings. By replicating this framework, Collaborative members continue to generate successful bundled payment models to support financial health now and in the future.
“The Premier team repeatedly exceeds all expectations in ensuring that we have up-to-date information and analytics,” said Patricia Emerson, DNP, RN, OCN, Director of Medical Oncology, Riverside Health System in Virginia. “Our partnership with Premier has been instrumental in our ability to navigate the Oncology Care Model, and network with other organizations facing the same challenges. Why reinvent the wheel if a colleague has already identified the project and completed the background work? Premier’s Bundled Payment Collaborative provides an essential venue for sharing and learning from each other. ”
Premier's Collaborative model enables access to the successful efforts of others in an efficient way, helping providers improve performance from both a timing and a resource consumption perspective.
Additional drivers of positive cost and quality outcomes identified by Premier members included:
- A focus on avoiding unnecessary inpatient admissions, emergency department visits and patient engagement/education specific to urgent care through improved symptom management
- Establishing an infrastructure to support bundled payments, such as a project manager
- Partnering with high-value post-acute providers, such as skilled nursing facilities
- Pre-admission and post-operative education, discharge planning and post-discharge follow up (e.g. patient navigation)
Both the OCM and CJR bundled payment models were created to support better and more efficient care for Medicare beneficiaries. The success of these programs, as well as the CMS Bundled Payment for Care Improvement Advanced model, are clear indicators that the value-based payment movement is rapidly increasing with no signs of slowing down. Health systems are increasingly creating high-value delivery networks that are funded through risk-based alternative payment models, such as bundled payments. As such, healthcare providers need a paced strategy to build the capabilities for success.
With over 140 healthcare facilities, Premier’s Bundled Payment Collaborative provides the opportunity for industry leaders to leverage sophisticated claims analytics, share insights and best practices, benchmark performance and build core capabilities that are needed for successful episode-based care delivery and payment models. Armed with clinical insights from data on more than 45 percent of U.S. hospital discharges, a proven performance improvement methodology and approximately $60 billion in annual spend information, Premier consultants work to meet the needs of healthcare providers as embedded partners through onsite assessments, one-on-one coaching, peer-to-peer collaboration, 24/7 on-demand data tools and virtual education.