Kindred Participating in Bundled Payment Initiative

By Ryan Squire

On Monday the Centers for Medicare and Medicaid Services (CMS) reported that 14 organizations – including Kindred Healthcare – have been selected to participate in Model 3 of their Bundled Payments for Care Improvements (BPCI) initiative.  The BPCI initiative seeks to evaluate the total cost of care for 60 days following an acute care hospitalization, and to have the quality of care improve while bringing down the overall cost.  That includes care delivered in multiple settings: home health, skilled nursing facilities, LTACH’s, and any time spent back in the acute care hospital if needed.

The effort will last three years and will test whether paying groups of providers a lump sum for a patient’s post-acute care treatment will lower overall costs while maintaining or improving the quality of patient care.  At the heart of the effort is improved care coordination and transitional care across sites of service.  Three Kindred locations in Cleveland are in the BPCI.  PeopleFirst Home Care & Hospice will support the BPCI project but is not a registered participant.

In the Initiative, Kindred is responsible for outcomes and financial performance for a 60 day episode of care, regardless of where that patient goes during the episode.  Diagnoses can vary in the CMS initiative, but Kindred has selected seven categories for review as part of the project, from pneumonia to congestive heart failure (CHF), from sepsis to lower extremity joint replacement.

Kindred has had an ongoing relationship with the Cleveland Clinic for several years, and the foundation of that relationship – quality improvement and cost-effective treatment – will help inform the BPCI project.  Weekly IDT meetings, review of best practices to avoid hospital re-admissions, IT interfaces that help the flow of digital information, and physician involvement in quality improvement can be the building blocks for the BPCI project.  New data tracking tools will be developed, and the introduction of care management teams or nurses will augment Kindred’s attempts to reduce unnecessary hospitalizations.

While still in the early stages – a no-risk phase runs from January to July of this year, followed by a final decision about whether to enter our facilities into the financial risk-period – Kindred is excited to be participating in this important innovation component of the Affordable Care Act of 2010.  It is through innovative programs like this one that we will, together, figure out how to bend the cost curve in health care and still deliver the high quality service our patients all need and deserve.