Nearly two-thirds of CJR participants in Premier’s Bundled Payment Collaborative received reconciliation payments from Medicare; BPCI participants also achieving positive results
CHARLOTTE, N.C. (November 20, 2017) — Hospital participants in the Centers for Medicare & Medicaid Services (CMS) Comprehensive Joint Replacement (CJR) model that are members of the Premier Inc. Bundled Payment Collaborative are substantially outperforming their peers, according to a Premier analysis of CMS’s preliminary CJR performance year 1 data. Approximately 63 percent of CJR participants in the Premier Bundled Payment Collaborative received positive savings payments from Medicare, outperforming their peers by 35 percent when compared to the 47 percent of CJR program participants that achieved positive savings payments nationally.
Though they make up six percent of all CJR program participants, Premier Collaborative CJR members also generated 11 percent of the total $37.5 million in Medicare savings distributed to all program participants. Additionally:
- More than half of Premier Collaborative members that received positive savings payments from Medicare achieved at least 10 percent in overall savings;
- Approximately 75 percent of Premier Collaborative members achieved savings for Medicare; and
- Approximately 80 percent of CJR participants in Premier’s Collaborative achieved excellent or good quality scores in the first two quarters of performance year one.
“These results show that with a customized and methodical approach, aligned providers across an episode, robust data and insights from peers and industry experts, and the implementation of best practice processes, Premier members are achieving significant financial and quality gains through the CJR program,” said Mark Hiller, vice president of Premier’s Bundled Payment Collaborative. “When done right, bundled payment models represent a smart business choice for providers to ensure continued economic viability in today’s value-based healthcare environment. They also present an opportunity to further align physicians and providers to innovate care delivery processes and achieve greater incentives through the Quality Payment Program as alternative payment models continue to evolve. We commend Bundled Payment Collaborative members for leading the way in this successful effort.”
Launched in April 2016, the CJR model aims to support better and more efficient care for Medicare beneficiaries undergoing hip and knee replacements. CMS has proposed lifting the mandatory requirements from the CJR model for half of its markets; however hospitals in the program can continue participating on a voluntary basis. In fact, CMS supports voluntary bundled payment program participation, such as through its Bundled Payment for Care Improvement (BPCI) initiative and its Oncology Care Model. Further, CMS is anticipating announcing a new episode payment model for 2018.
Members of Premier’s Bundled Payment Collaborative participating in BPCI are also achieving positive results. For example, Bundled Payment Collaborative member Southwest General Health Center, a 350-bed hospital located in Middleburg Heights, Ohio, has earned nearly $800,000 in savings payments since 2015, as part of the BPCI model. In addition, 30-day readmissions at Southwest General have decreased by 21 percent and 90-day readmissions have decreased by 20 percent.
“We became a BPCI participant because we saw a great opportunity to drive quality improvements and save money at the same time,” said Jill Barber, executive director, Payer Strategy and Population Health, Southwest General. “Bundles provide us a way to ensure everyone across the continuum is at the table in achieving success. Regardless of what political sphere you’re from, we believe that bundled payment models are a mechanism in which the healthcare industry will continue to adopt in its movement from fee-for-service to paying for high-quality, value-based care. We eagerly await the CMS announcement of a new bundled payment model, as we plan to participate. Also, we are excited to continue to partner with Premier in this effort, as our participation in the collaborative is key to driving positive results through data, insights and best practices.”
With more than 120 healthcare facilities, Premier’s Bundled Payment Collaborative is one of the largest collaboratives of healthcare provider systems in the U.S. focused on episode-based care. The Collaborative provides the opportunity for leading health systems to analyze and identify opportunities from sophisticated claims analytics, share insights and knowledge, benchmark performance, and learn core capabilities, as well as leading and evolving practices from each other to reduce the learning curve and accelerate success in implementing effective bundled payment models. Premier’s industry-leading consultants partner with healthcare organizations pursuing commercial, mandatory and voluntary bundled payment models, such as BPCI and the Oncology Care Model. Premier has been named Best in KLAS for value-based care consulting for the past two years.
BPCI Awardee Agreement Statement
The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.
About Premier Inc.
Premier Inc. (NASDAQ: PINC) is a leading healthcare improvement company, uniting an alliance of approximately 3,900 U.S. hospitals and health systems and approximately 150,000 other providers and organizations. With integrated data and analytics, collaboratives, supply chain solutions, and advisory and other services, Premier enables better care and outcomes at a lower cost. Premier, a Malcolm Baldrige National Quality Award recipient, plays a critical role in the rapidly evolving healthcare industry, collaborating with members to co-develop long-term innovations that reinvent and improve the way care is delivered to patients nationwide. Headquartered in Charlotte, N.C., Premier is passionate about transforming American healthcare. Please visit Premier’s news and investor sites on www.premierinc.com; as well as Twitter, Facebook, LinkedIn, YouTube, Instagram and Premier’s blog for more information about the company.