CMS, Centers for Medicare & Medicaid Services, leads the insurance industry in policy guidelines and procedures that other commercial and private insurances are following. In particular, bundling items. Bundling is a method used to originally define services and procedures that are related directly to the patient’s primary condition. The Affordable Care Act made way for new payment methods that allow CMS to navigate away from fee-for-service. Deirdre Baggot PhD, specializes in bundle payments in the health care industry.
Deirdre Baggot PhD is well versed in the reform of healthcare payment and is highly respected. Gaining experience as a clinician who established bundled payments, she has directed consulting practices to focus on bundled payments and innovation and has produced over $5 million in revenue annually. She graduated from Southern Illinois University with Bachelor of Science in Nursing then attended Loyola University Graduate School of Business where she received Master of Business Administration degree. Continuing her education, she graduated from University of Colorado where she received her Doctorate of Philosophy. Visit vimeo.com to know more about Baggot
When CMS bundles certain items, the costs associated with the item go down and quality improves, saving CMS money in the long run, particularly in the post-acute care. The healthcare system is very complex which makes for vast challenges but multitudes of opportunity. Taking small manageable steps will allow insurance to develop innovative care models that will encourage physicians to follow.
Bundling post-acute services consists of trying to avoid re-admissions, mainly after major joint replacement, congestive heart failure, coronary artery bypass graft, chronic obstructive pulmonary disease, including bronchitis and asthma, and percutaneous coronary intervention. The care needed for a patient will include three days prior to an inpatient stay to up to 90 days.
The more expensive conditions, like cardiac and orthopedic procedures, are the perfect candidates for bundling. CMS has researched and has transitioned within the last several years to create a payment reform to use rather than fee-for-service.