
ICYMI: Notes from the field for January 2020
The new year is bringing a lot of reviews of healthcare trends from 2019 and speculation about what 2020 will bring. Meanwhile, new studies and policy changes continue to make headlines. Here’s what caught our eye in January.
Some savings in bundles — more to come?
- Several news outlets picked up a new study from Health Affairs, which found that bundled payments reduce spending on joint replacements, but haven’t achieved savings for other conditions. That’s not necessarily as grim as it sounds. It may take up to four years for full savings in Bundled Payments for Care Improvement-Advanced and other programs to materialize.
- When it comes to bundled payments for spine care, one surgeon urges his colleagues to be patient. Jeffery Wang, MD, of the USC Spine Center at Keck Medicine of USC in Los Angeles, hopes that the value potential of bundled payments will overcome the initial pushback from some providers.
- As CMS looks to its new Oncology bundled model, some industry experts are weighing in with their recommendations. Whether CMS will listen remains to be seen.
Recent developments and possible 2020 trends
- Among Health Affairs’ predicted emerging healthcare issues in 2020 is the introduction of a bundled payment plan for maternal and infant care. The U.S. currently has the worst maternal health outcomes in the developed world, so this might be part of what’s needed to drive change.
- Accountable Care Organizations made a strong showing when it comes to savings in 2018. ACOs reduced spending by about 1.11%, returning more than $184 million to the Medicare Trust Fund.
- As more ACOs take on downside risk, home health organizations may see a boost in the coming months. ACOs are starting to find ways to avoid costly facility-based post-acute care — and home health groups are proving to be a cost-effective partner.
- Despite those gains, the ACO program has continued to see participants drop out. There are 517 ACOs in the Medicare program now, down from 561 at this point in 2018.
Policy news and updates
- DataGen has long argued for the benefits of value-based care approaches. This month, Managed Healthcare Executive shares some of the administrative benefits that VBC can drive, including lumping transactions together and improving care quality.
- The 2020 Outpatient Prospective Payment rule has been finalized. DataGen analyzed the rule and found some key impacts participants should be aware of.
- Two states (Maine and Connecticut) have added bundled payments to their state employee health plans, igniting speculation that it will encourage more providers to participate. If successful, these models could help more providers get on board with bundles.