July 2014
YNHHS participating in Medicare initiative

As of April 1, Yale New Haven Health System hospitals are voluntarily participating in the Medicare initiative called Bundled Payments for Care Improvement Model 2. YNHHS has chosen to participate in two major patient care areas of the initiative: Heart and Vascular, and Orthopedics. The initiative goal is to provide patient-centered, cost-effective care that improves patient outcomes.

Yale New Haven will work with Remedy Partners – a company that coordinates with hospitals and home care agencies to help them improve patient care transitions – and jointly provide care coordination for acute and post-acute services delivered to fee-for-service Medicare beneficiaries from the time of the patient’s admission until 90 days after discharge from the hospital.

Remedy Partners works closely with patients and their outpatient providers to monitor status throughout their 90-day episode, whether the patient goes home or to a skilled nursing facility. Remedy Partners tracks the patient’s medications and treatment plan goals, coordinates follow-up appointments and updates the patient’s status. Remedy Partners also provides a 24/7 nurse call center to help the patient avoid emergency department visits and unnecessary hospitalizations.

Although all physician, hospital and post-acute payments continue to be paid at Medicare rates, Medicare will eventually settle the actual payment experience with the targeted bundled rate.

Participating in this important Medicare initiative will help us develop evidence-based care that improves outcomes and is truly more-patient centered. Yale New Haven Health and its physicians will be rewarded for care that prevents readmissions and provides the highest quality post-acute care during the 90 days.

This reimbursement model, while currently only a Medicare demonstration project, is likely to be a major driver for accountable care reform. Bridgeport Hospital is participating early in this initiative to learn from the experiences with heart and vascular, and orthopedic patients to provide better population health and disease management for all patients in the years ahead.