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{mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} </style> <![endif]--> </head> <body lang=EN-US link=blue vlink=purple style='tab-interval:.5in'> <div class=Section1> <p class=MsoNormal style='margin-left:120.0pt;text-indent:-120.0pt;tab-stops: 120.0pt;mso-layout-grid-align:none;text-autospace:none'><b><span style='font-family:"Calibri","sans-serif";mso-bidi-font-family:Calibri; color:black'>From:<span style='mso-tab-count:1'>                              </span></span></b><span style='font-family:"Calibri","sans-serif";mso-bidi-font-family:Calibri; color:black'>Centers for Medicare &amp; Medicaid Services [cmslists@subscriptions.cms.hhs.gov]<o:p></o:p></span></p> <p class=MsoNormal style='margin-left:120.0pt;text-indent:-120.0pt;tab-stops: 120.0pt;mso-layout-grid-align:none;text-autospace:none'><b><span style='font-family:"Calibri","sans-serif";mso-bidi-font-family:Calibri; color:black'>Sent:<span style='mso-tab-count:1'>                               </span></span></b><span style='font-family:"Calibri","sans-serif";mso-bidi-font-family:Calibri; color:black'>Tuesday, August 23, 2011 12:26 PM<o:p></o:p></span></p> <p class=MsoNormal style='margin-left:120.0pt;text-indent:-120.0pt;tab-stops: 120.0pt;mso-layout-grid-align:none;text-autospace:none'><b><span style='font-family:"Calibri","sans-serif";mso-bidi-font-family:Calibri; color:black'>To:<span style='mso-tab-count:1'>                                   </span></span></b><span style='font-family:"Calibri","sans-serif";mso-bidi-font-family:Calibri; color:black'>Debora Philips<o:p></o:p></span></p> <p class=MsoNormal style='margin-left:120.0pt;text-indent:-120.0pt;tab-stops: 120.0pt;mso-layout-grid-align:none;text-autospace:none'><b><span style='font-family:"Calibri","sans-serif";mso-bidi-font-family:Calibri; color:black'>Subject:<span style='mso-tab-count:1'>                          </span></span></b><span style='font-family:"Calibri","sans-serif";mso-bidi-font-family:Calibri; color:black'>HHS NEWS: Bundled Payments for Care Improvement Initiative: Request for Applications (CMS-5504-N)<o:p></o:p></span></p> <p class=MsoNormal><o:p>&nbsp;</o:p></p> <p class=MsoNormal><span style='font-size:9.0pt;font-family:"Arial","sans-serif"; mso-fareast-font-family:"Times New Roman"'><a href="http://links.govdelivery.com:80/track?type=click&amp;enid=bWFpbGluZ2lkPTE0NDU4NDAmbWVzc2FnZWlkPVBSRC1CVUwtMTQ0NTg0MCZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTEyNzY2NzAwNDAmZW1haWxpZD1kZWJvcmEucGhpbGlwc0Bwb2xhcmlzLWdyb3VwLmNvbSZ1c2VyaWQ9ZGVib3JhLnBoaWxpcHNAcG9sYXJpcy1ncm91cC5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&amp;&amp;&amp;100&amp;&amp;&amp;http://www.cms.hhs.gov/" target=null title="CMS Banner"><span style='text-decoration:none;text-underline: none'><img border=0 id="_x0000_i1025" src="https://service.govdelivery.com/banners/CMS_banner.jpg" alt="CMS Banner"></span></a><o:p></o:p></span></p> <p><strong><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>DEPARTMENT OF HEALTH &amp; HUMAN SERVICES</span></strong><span style='font-size:9.0pt; font-family:"Arial","sans-serif"'> <br> Centers for Medicare &amp; Medicaid Services <br> Room 352-G <br> 200 Independence Avenue, SW <br> Washington, DC 20201 <br> Office of Media Affairs <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><!--RSS_SECTION-->FOR IMMEDIATE RELEASE</b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Contact:</b>&nbsp; HHS Press Office<span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>Tuesday, August 23, 2011&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (202) 690-6343<span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal align=center style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:center'><b>Affordable Care Act initiative to lower costs, help doctors and hospitals coordinate care</b><span style='font-size:9.0pt; font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal align=center style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:center'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>The U.S. Department of Health and Human Services (HHS) today announced a new initiative to help improve care for patients while they are in the hospital and after they are discharged. Doctors, hospitals, and other health care providers can now apply to participate in a new program known as the Bundled Payments for Care Improvement initiative (Bundled Payments initiative). Made possible by the Affordable Care Act, it will align payments for services delivered across an episode of care, such as heart bypass or hip replacement, rather than paying for services separately.&nbsp; Bundled payments will give doctors and hospitals new incentives to coordinate care, improve the quality of care and save money for Medicare. <span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'> Patients don t get care from just one person  it takes a team, and this initiative will help ensure the team is working together, said HHS Secretary Kathleen Sebelius. &nbsp; The Bundled Payments initiative will encourage doctors, nurses and specialists to coordinate care. It is a key part of our efforts to give patients better health, better care, and lower costs. <span style='font-size: 9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>In Medicare currently, hospitals, physicians and other clinicians who provide care for beneficiaries bill and are paid separately for their services.&nbsp; This Centers for Medicare &amp; Medicaid Services (CMS) initiative will bundle care for a package of services patients receive to treat a specific medical condition during a single hospital stay and/or recovery from that stay  this is known as an episode of care.&nbsp; By bundling payment across providers for multiple services, providers will have a greater incentive to coordinate and ensure continuity of care across settings, resulting in better care for patients.&nbsp; Better coordinated care can reduce unnecessary duplication of services, reduce preventable medical errors, help patients heal without harm, and lower costs. <span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>The Bundled Payments initiative is being launched by the new Center for Medicare and Medicaid Innovation (Innovation Center), which was created by the Affordable Care Act to carry out the critical task of finding new and better ways to provide and pay for health care to a growing population of Medicare and Medicaid beneficiaries. <span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>Released today, the Innovation Center s Request for Applications (RFA) outlines four broad approaches to bundled payments.&nbsp; Providers will have flexibility to determine which episodes of care and which services will be bundled together.&nbsp; By giving providers the flexibility to determine which model of bundled payments works best for them, it will be easier for providers of different sizes and readiness to participate in this initiative.<span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'> This Bundled Payment initiative responds to the overwhelming calls from the hospital and physician communities for a flexible approach to patient care improvement, said CMS Administrator Donald Berwick, M.D.&nbsp;  All around the country, many of the leading health care institutions have already implemented these kinds of projects and seen positive results. <span style='font-size:9.0pt;font-family: "Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>The Bundled Payments initiative is based on research and previous demonstration projects that suggest this approach has tremendous potential. For example, a Medicare heart bypass surgery bundled payment demonstration saved the program $42.3 million, or roughly 10 percent of expected costs, and saved patients $7.9 million in coinsurance while improving care and lowering hospital mortality.&nbsp; <span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'> From a patient perspective, bundled payments make sense.&nbsp; You want your doctors to collaborate more closely with your physical therapist, your pharmacist and your family caregivers.&nbsp; But that sort of common sense practice is hard to achieve without a payment system that supports coordination over fragmentation and fosters the kinds of relationships we expect our health care providers to have, said Dr. Berwick.<span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>Organizations interested in applying to the Bundled Payments for Care Improvement initiative must submit a Letter of Intent (LOI) no later than September 22, 2011 for Model 1 and November 4, 2011 for Models 2, 3, and 4. For more information about the various models and the initiative itself, please see the Bundled Payments for Care Improvement initiative web site at: <span style='font-size:9.0pt; font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><a href="http://links.govdelivery.com:80/track?type=click&amp;enid=bWFpbGluZ2lkPTE0NDU4NDAmbWVzc2FnZWlkPVBSRC1CVUwtMTQ0NTg0MCZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTEyNzY2NzAwNDAmZW1haWxpZD1kZWJvcmEucGhpbGlwc0Bwb2xhcmlzLWdyb3VwLmNvbSZ1c2VyaWQ9ZGVib3JhLnBoaWxpcHNAcG9sYXJpcy1ncm91cC5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&amp;&amp;&amp;101&amp;&amp;&amp;http://www.innovations.cms.gov/areas-of-focus/patient-care-models/bundled-payments-for-care-improvement.html"><span style='font-size:12.0pt;font-family:"Times New Roman","serif";color:purple'>http://www.innovations.cms.gov/areas-of-focus/patient-care-models/bundled-payments-for-care-improvement.html</span></a></span>.<span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>Interested parties may obtain answers to specific questions by e-mailing CMS at: <span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><a href="mailto:BundledPayments@cms.hhs.gov"><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>BundledPayments@cms.hhs.gov</span></a></span>.<span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>This initiative is part of a broader effort by the Obama Administration to improve health, improve care, and lower costs. A brief summary of other efforts, including those authorized by the Affordable Care Act, can be found at: <span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><a href="http://links.govdelivery.com:80/track?type=click&amp;enid=bWFpbGluZ2lkPTE0NDU4NDAmbWVzc2FnZWlkPVBSRC1CVUwtMTQ0NTg0MCZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTEyNzY2NzAwNDAmZW1haWxpZD1kZWJvcmEucGhpbGlwc0Bwb2xhcmlzLWdyb3VwLmNvbSZ1c2VyaWQ9ZGVib3JhLnBoaWxpcHNAcG9sYXJpcy1ncm91cC5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&amp;&amp;&amp;102&amp;&amp;&amp;http://www.healthcare.gov/news/factsheets/deliverysystem07272011a.html"><span style='font-size:12.0pt;font-family:"Times New&#13;&#10; Roman","serif"; color:purple'>www.HealthCare.gov/news/factsheets/deliverysystem07272011a.html</span></a> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>For more information about the CMS Innovation Center, please visit: <span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><a href="http://links.govdelivery.com:80/track?type=click&amp;enid=bWFpbGluZ2lkPTE0NDU4NDAmbWVzc2FnZWlkPVBSRC1CVUwtMTQ0NTg0MCZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTEyNzY2NzAwNDAmZW1haWxpZD1kZWJvcmEucGhpbGlwc0Bwb2xhcmlzLWdyb3VwLmNvbSZ1c2VyaWQ9ZGVib3JhLnBoaWxpcHNAcG9sYXJpcy1ncm91cC5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&amp;&amp;&amp;103&amp;&amp;&amp;http://www.innovations.cms.gov/"><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>http://www.innovations.cms.gov</span></a></span>.<span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>Additional information: <span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>HHS fact sheet - <span style='color:black'><a href="http://links.govdelivery.com:80/track?type=click&amp;enid=bWFpbGluZ2lkPTE0NDU4NDAmbWVzc2FnZWlkPVBSRC1CVUwtMTQ0NTg0MCZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTEyNzY2NzAwNDAmZW1haWxpZD1kZWJvcmEucGhpbGlwc0Bwb2xhcmlzLWdyb3VwLmNvbSZ1c2VyaWQ9ZGVib3JhLnBoaWxpcHNAcG9sYXJpcy1ncm91cC5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&amp;&amp;&amp;104&amp;&amp;&amp;http://www.healthcare.gov/news/factsheets/bundling08232011a.html" target="_blank">http://www.healthcare.gov/news/factsheets/bundling08232011a.html</a> </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>Federal Register Posting - <span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><a href="http://links.govdelivery.com:80/track?type=click&amp;enid=bWFpbGluZ2lkPTE0NDU4NDAmbWVzc2FnZWlkPVBSRC1CVUwtMTQ0NTg0MCZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTEyNzY2NzAwNDAmZW1haWxpZD1kZWJvcmEucGhpbGlwc0Bwb2xhcmlzLWdyb3VwLmNvbSZ1c2VyaWQ9ZGVib3JhLnBoaWxpcHNAcG9sYXJpcy1ncm91cC5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&amp;&amp;&amp;105&amp;&amp;&amp;http://www.ofr.gov/OFRUpload/OFRData/2011-21707_PI.pdf"><span style='font-size:12.0pt;font-family:"Times New Roman","serif";color:purple'>http://www.ofr.gov/OFRUpload/OFRData/2011-21707_PI.pdf</span></a> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal align=center style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:center'>###<span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><span style='font-size:20.0pt;font-family:"Times","serif";mso-bidi-font-family:Arial'>CMS TECHNICAL FACT SHEET</span></b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Times","serif";mso-bidi-font-family:Arial'>FOR IMMEDIATE RELEASE &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Contact: CMS Media Relations Group</span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:"Times","serif";mso-bidi-font-family:Arial'>August 23, 2011&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;(202) 690-6145</span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b>Bundled Payments for Care Improvement Initiative</b><span style='font-size:9.0pt; font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><u>OVERVIEW</u></b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>The Affordable Care Act provides a number of new tools and resources to help improve health care and lower costs for all Americans.&nbsp; Bundling payment for services that patients receive across a single episode of care, such as heart bypass surgery or a hip replacement, is one way to encourage doctors, hospitals and other health care providers to work together to better coordinate care for patients both when they are in the hospital and after they are discharged. Such initiatives can help improve health, improve the quality of care, and lower costs.&nbsp; <span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>The Centers for Medicare &amp; Medicaid Services (CMS) is working in partnership with providers to develop models of bundling payments through the Bundled Payments initiative.&nbsp; On August 23, 2011, CMS invited providers to apply to help test and develop four different models of bundling payments. Through the Bundled Payments initiative, providers have great flexibility in selecting conditions to bundle, developing the health care delivery structure, and determining how payments will be allocated among participating providers.<span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><u>BACKGROUND</u></b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>Medicare currently makes separate payments to providers for the services they furnish to beneficiaries for a single illness or course of treatment, leading to fragmented care with minimal coordination across providers and health care settings.&nbsp; Payment is based on how much a provider does, not how well the provider does in treating the patient.&nbsp; Under the Bundled Payment initiative, CMS would link payments for multiple services patients receive during an episode of care.&nbsp; For example, instead of a surgical procedure generating multiple claims from multiple providers, the entire team is compensated with a  bundled payment that provides incentives to deliver health care services more efficiently while maintaining or improving quality of care.&nbsp;Providers will have flexibility to determine which episodes of care and which services would be bundled together.&nbsp; <span style='font-size: 9.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>Research has shown that bundled payments can align incentives for providers  hospitals, post acute care providers, doctors, and other practitioners to partner closely across all specialties and settings that a patient may encounter to improve the patient s experience of care during a hospital stay in an acute care hospital, and during post-discharge recovery.&nbsp; <span style='font-size:9.0pt; font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>The Bundled Payments for Care Improvement Initiative is one more step in an effort across the Department of Health and Human Services (HHS) to help all Americans enjoy better health, improve the quality of health care, and reduce costs by replacing fragmented care with care that is coordinated and that is guided by the patient s needs and wishes.&nbsp; Other recent activities by CMS and HHS to promote improvement in the health care delivery system include:<span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-family:Symbol;mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>Creating user-friendly tools for patients and their caretakers to compare the quality of care offered by providers and suppliers in their communities.&nbsp; All quality information can now be found on the CMS Web site at: <span style='font-size: 9.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><a href="http://links.govdelivery.com:80/track?type=click&amp;enid=bWFpbGluZ2lkPTE0NDU4NDAmbWVzc2FnZWlkPVBSRC1CVUwtMTQ0NTg0MCZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTEyNzY2NzAwNDAmZW1haWxpZD1kZWJvcmEucGhpbGlwc0Bwb2xhcmlzLWdyb3VwLmNvbSZ1c2VyaWQ9ZGVib3JhLnBoaWxpcHNAcG9sYXJpcy1ncm91cC5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&amp;&amp;&amp;106&amp;&amp;&amp;http://www.medicare.gov/quality-care-finder/index.html"><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>http://www.medicare.gov/quality-care-finder/index.html</span></a></span>; <span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-.25in'><span style='font-family:Symbol;mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>Launching the Partnership for Patients to encourage hospitals, physicians and other providers to partner with the Department to focus on improving patient safety across all health care settings.&nbsp; The Partnership is expected to save 60,000 lives and more than $35 billion in health care costs, including up to $10 billion in Medicare costs, over the next three years.&nbsp; In the first few months, more than 4,000 organizations, including more than 2,000 hospitals, have taken the Partnership for Patients pledge.&nbsp; More information can be found at: <span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><a href="http://links.govdelivery.com:80/track?type=click&amp;enid=bWFpbGluZ2lkPTE0NDU4NDAmbWVzc2FnZWlkPVBSRC1CVUwtMTQ0NTg0MCZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTEyNzY2NzAwNDAmZW1haWxpZD1kZWJvcmEucGhpbGlwc0Bwb2xhcmlzLWdyb3VwLmNvbSZ1c2VyaWQ9ZGVib3JhLnBoaWxpcHNAcG9sYXJpcy1ncm91cC5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&amp;&amp;&amp;107&amp;&amp;&amp;http://www.healthcare.gov/center/programs/partnership/index.html"><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>http://www.healthcare.gov/center/programs/partnership/index.html</span></a></span>; and<span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-.25in'><span style='font-family:Symbol;mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>Tying payment for services to the quality of care through Pay for Performance, starting with the payment systems for dialysis services and most recently for hospital inpatient care, and laying the groundwork for achieving similar results in other payment systems.&nbsp; <span style='font-size:9.0pt; font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>A brief summary of the Department s activities, <i>Lower Costs, Better Care: Reforming Our Health Care Delivery System</i>, including information about new initiatives authorized by the Affordable Care Act can be found at: <span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><a href="http://links.govdelivery.com:80/track?type=click&amp;enid=bWFpbGluZ2lkPTE0NDU4NDAmbWVzc2FnZWlkPVBSRC1CVUwtMTQ0NTg0MCZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTEyNzY2NzAwNDAmZW1haWxpZD1kZWJvcmEucGhpbGlwc0Bwb2xhcmlzLWdyb3VwLmNvbSZ1c2VyaWQ9ZGVib3JhLnBoaWxpcHNAcG9sYXJpcy1ncm91cC5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&amp;&amp;&amp;108&amp;&amp;&amp;http://www.healthcare.gov/news/factsheets/deliverysystem07272011a.html"><span style='font-size:12.0pt;font-family:"Times New Roman","serif";color:purple'>http://www.healthcare.gov/news/factsheets/deliverysystem07272011a.html</span></a> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><u>BUNDLED PAYMENTS FOR CARE IMPROVEMENT</u></b><span style='font-size:9.0pt;font-family: "Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>The Centers for Medicare &amp; Medicaid Services (CMS) is working in partnership with providers to develop models of bundling payments through the Bundled Payments Initiative.&nbsp; The Bundled Payments initiative is seeking applications for four broadly defined models of care, three of which would involve a retrospective bundled payment arrangement, with a target price (target payment amount) for a defined episode of care.&nbsp; <span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><i>Retrospective Payment Bundling</i><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>In these models, CMS and providers would set a target payment amount for a defined episode of care.&nbsp; Applicants would propose the target price, which would be set by applying a discount to total costs for a similar episode of care as determined from historical data.&nbsp; Participants in these models would be paid for their services under the Original Medicare fee-for-service (FFS) system, but at a negotiated discount.&nbsp; At the end of the episode, the total payments would be compared with the target price.&nbsp; Participating providers may then be able to share in those savings.&nbsp; <span style='font-size:9.0pt; font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>In Model 1, the episode of care would be defined as the inpatient stay in the general acute care hospital. Medicare will pay the hospital a discounted amount based on the payment rates established under the Inpatient Prospective Payment System (IPPS).&nbsp; Medicare will pay physicians separately for their services under the Medicare Physician Fee Schedule.&nbsp; Hospitals and physicians will be permitted to share gains arising from better coordination of care.&nbsp; <span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>In Model 2, the episode of care would include the inpatient stay and post-acute care and would end, at the applicant s option, either a minimum of 30 or 90 days after discharge, while in Model 3, the episode of care would begin at discharge from the inpatient stay and would end no sooner than 30 days after discharge. &nbsp;In both Models 2 and 3, the bundle would include physicians services, care by a post-acute provider, related readmissions, and other services proposed in the episode definition such as clinical laboratory services; durable medical equipment, prosthetics, orthotics and supplies (DMEPOS); and Part B drugs.&nbsp; The target price will be discounted from an amount based on the applicant s historical fee-for-service payments for the episode.&nbsp; Payments will be made at the usual fee-for-service payment rates, after which the aggregate Medicare payment for the episode will be reconciled against the target price.&nbsp; Any reduction in expenditures beyond the discount reflected in the target price will be paid to the participants to share among the participating providers.&nbsp; <span style='font-size:9.0pt; font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><i>Prospective Payment Bundling</i><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>Under Model 4, CMS would make a single, prospectively determined bundled payment to the hospital that would encompass all services furnished during the inpatient stay by the hospital, physicians and other practitioners.&nbsp; Physicians and other practitioners would submit  no-pay claims to Medicare and would be paid by the hospital out of the bundled payment.<span style='font-size:9.0pt; font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>A side-by-side comparison of key features of the four models can be found below.<span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><u>Gainsharing Arrangements:</u></b>&nbsp; In addition to streamlining care through the use of bundles, the proposals for this initiative may include gainsharing arrangements.&nbsp; Gainsharing refers to payments that may be made by hospitals and other providers to physicians and other practitioners as a result of collaborative efforts to improve quality and efficiency.&nbsp; These payments can further align incentives for health care providers to coordinate care, improve quality and efficiency of care, and partner in the improvement of care delivery.&nbsp; <span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><u>Additional Information about Applying for the Bundle Payments for Care Improvement initiative:</u></b> Organizations are welcome and encouraged to apply for and participate in one or more models.&nbsp; Providers participating in Accountable Care Organizations wishing to use this opportunity to improve care coordination and the quality of care are welcome to do so.&nbsp; For more information on applicant eligibility, please review the  Conditions of Participation section of the RFA.&nbsp; <span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>Applicants will be required to identify the clinical condition(s) through MS-DRGs, define the time period for the episode of care, and identify the services included in the bundled payment, among other criteria.&nbsp; Applicants will also be required to plan and implement quality assurance and improvement activities as a condition of participation in this initiative and participate in CMS quality monitoring by reporting appropriate quality measures. &nbsp;During the demonstration, CMS will carefully monitor the program to ensure improved clinical quality, patient experience, and outcomes of care throughout participation in the initiative.&nbsp; Applicants will be required to propose strong patient protections that preserve beneficiary choice in seeking care from the provider of their choice.<span style='font-size:9.0pt;font-family: "Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>To help facilitate health care innovation, recognize the diversity of provider organizations, and cultivate strong provider partnerships, applicants are asked to submit their own episode definitions and bundled payment proposals.&nbsp; CMS will provide historical Medicare claims data to potential applicants planning to apply for Models 2-4. &nbsp;The data are intended to enable potential applicants to develop well-defined episodes and discount proposals based on the experience of providers in the applicant s area.&nbsp; In order to be considered for receipt of data, applicants must submit a Research Study Protocol along with their letter of intent (LOI) and will later be expected to submit and comply with a Data Use Agreement (DUA).&nbsp; Both of these forms are available on the Bundled Payments for Care Improvement website.<span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><u>Deadlines for Letters of Intent and Applications:</u></b>&nbsp; Applicants for Model 1 must submit a nonbinding LOI by September 22, 2011 and a completed application by October 21, 2011.&nbsp; Applicants for Models 2-4, must submit a nonbinding LOI by November 4, 2011; applicants who wish to receive historical Medicare claims data must complete a Research Request Packet by November 4, 2011 as well.&nbsp; If approved to receive Medicare data, applicants must submit a DUA prior to receipt of data.&nbsp; Completed applications for Models 2-4 must be submitted by no later than by March 15, 2012.&nbsp; <span style='font-size: 9.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>For more information please refer to the RFA and application found at: <span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><a href="http://links.govdelivery.com:80/track?type=click&amp;enid=bWFpbGluZ2lkPTE0NDU4NDAmbWVzc2FnZWlkPVBSRC1CVUwtMTQ0NTg0MCZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTEyNzY2NzAwNDAmZW1haWxpZD1kZWJvcmEucGhpbGlwc0Bwb2xhcmlzLWdyb3VwLmNvbSZ1c2VyaWQ9ZGVib3JhLnBoaWxpcHNAcG9sYXJpcy1ncm91cC5jb20mZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&amp;&amp;&amp;109&amp;&amp;&amp;http://www.innovations.cms.gov/"><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>www.innovations.cms.gov</span></a></span> or email at <span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><a href="mailto:BundledPaymentsXXX@cms.hhs.gov"><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>BundledPayments@cms.hhs.gov</span></a></span>.<span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal align=right style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:right'><b><span style='font-size:10.0pt;font-family:"Arial","sans-serif"'>APPENDIX</span></b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal align=right style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:right'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal align=center style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:center'><b><span style='font-size:10.0pt;font-family:"Arial","sans-serif"'>BUNDLED PAYMENTS FOR CARE IMPROVEMENT INITIATIVE</span></b><span style='font-size:9.0pt; font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal align=center style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:center'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal align=center style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:center'><b><i><span style='font-size:10.0pt;font-family:"Arial","sans-serif"'>KEY FEATURES OF BUNDLED PAYMENT MODELS COMPARED</span></i></b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 style='border-collapse:collapse;mso-yfti-tbllook:1184;mso-padding-alt:0in 0in 0in 0in'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td width=103 valign=top style='width:77.4pt;border:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:right'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal><span style='font-size:9.0pt;font-family:"Arial","sans-serif"; mso-fareast-font-family:"Times New Roman"'><br clear=all style='mso-special-character: line-break'> <o:p></o:p></span></p> <p class=MsoNormal align=right style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:right'><b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>MODEL</span></b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>FEATURE</span></b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border:solid windowtext 1.0pt; border-left:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:center'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal align=center style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:center'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal align=center style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:center'><b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>MODEL 1  </span></b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal align=center style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:center'><b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Inpatient Stay Only</span></b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border:solid windowtext 1.0pt; border-left:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:center'><b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>MODEL 2  </span></b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal align=center style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:center'><b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Inpatient Stay plus Post-discharge Services</span></b><span style='font-size:9.0pt; font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border:solid windowtext 1.0pt; border-left:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:center'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal align=center style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:center'><b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>MODEL 3  </span></b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p class=MsoNormal align=center style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:center'><b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Post-discharge Services Only</span></b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border:solid windowtext 1.0pt; border-left:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:center'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal align=center style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:center'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal align=center style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:center'><b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>MODEL 4  </span></b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'><o:p></o:p></span></p> <p class=MsoNormal align=center style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:center'><b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Inpatient Stay Only</span></b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:1'> <td width=103 valign=top style='width:77.4pt;border:solid windowtext 1.0pt; border-top:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Eligible Awardees</span></b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-9.0pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Physician group practices <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-9.0pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Acute care hospitals paid under the IPPS <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-9.0pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Health systems <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-9.0pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Physician-hospital organizations <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-9.0pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Conveners of participating health care providers <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-6.9pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Physician group practices <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-6.9pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Acute care hospitals paid under the IPPS <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-6.9pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Health systems <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-6.9pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Physician-hospital organizations <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-6.9pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Post-acute providers <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-6.9pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Conveners of participating health care providers <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-6.9pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Physician group practices <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-6.9pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Acute care hospitals paid under the IPPS <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-6.9pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Health systems <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-6.9pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Long-term care hospitals <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-6.9pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Inpatient rehabilitation facilities <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-6.9pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Skilled nursing facilities <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-6.9pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Home health agency <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-6.9pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Physician-hospital organizations <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-6.9pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Conveners of participating health care providers <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-9.0pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Physician group practices <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-9.0pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Acute care hospitals paid under the IPPS <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-9.0pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Health systems <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-9.0pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Physician-hospital organizations <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-9.0pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Conveners of participating health care providers <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:2'> <td width=103 valign=top style='width:77.4pt;border:solid windowtext 1.0pt; border-top:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Payment of Bundle and Target Price</span></b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Discounted IPPS payment; no separate target price <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Retrospective comparison of target price and actual FFS payments <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Retrospective comparison of target price and actual FFS payments <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Prospectively set payment <o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:3'> <td width=103 valign=top style='width:77.4pt;border:solid windowtext 1.0pt; border-top:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Clinical Conditions Targeted</span></b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>All MS-DRGs <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Applicants to propose based on MS-DRG for inpatient hospital stay <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Applicants to propose based on MS-DRG for inpatient hospital stay <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Applicants to propose based on MS-DRG for inpatient hospital stay <o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:4'> <td width=103 valign=top style='width:77.4pt;border:solid windowtext 1.0pt; border-top:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Types of Services Included in Bundle</span></b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Inpatient hospital services <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-9.05pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Inpatient hospital and physician services <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-9.05pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Related post-acute care services <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-9.05pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Related readmissions <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-9.05pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Other services defined in the bundle <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-9.05pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Post-acute care services <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-9.05pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Related readmissions <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-9.05pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Other services defined in the bundle <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-9.05pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Inpatient hospital and physician services <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-9.05pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Related readmissions <o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:5'> <td width=103 valign=top style='width:77.4pt;border:solid windowtext 1.0pt; border-top:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Expected Discount Provided to Medicare</span></b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>To be proposed by applicant; CMS requires minimum discounts increasing from 0% in first 6 mos. to 2% in Year 3 <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>To be proposed by applicant; CMS requires minimum discount of 3% for 30-89 days post-discharge episode; 2% for 90 days or longer episode <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>To be proposed by applicant <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>To be proposed by applicant; subject to minimum discount of 3%; larger discount for MS-DRGs in ACE Demonstration <o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:6'> <td width=103 valign=top style='width:77.4pt;border:solid windowtext 1.0pt; border-top:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Payment from CMS to Providers</span></b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-9.0pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Acute care hospital: IPPS payment less pre-determined discount <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; text-indent:-9.0pt'><span style='font-size:9.0pt;font-family:Symbol; mso-bidi-font-family:Arial'>·</span><span style='font-size:7.0pt'>&nbsp;&nbsp; </span><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Physician: Traditional fee schedule payment (not included in episode or subject to discount) <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Traditional fee-for-service payment to all providers and suppliers, subject to reconciliation with predetermined target price <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Traditional fee-for-service payment to all providers and suppliers, subject to reconciliation with predetermined target price <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Prospectively established bundled payment to admitting hospital; hospitals distribute payments from bundled payment <o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:7;mso-yfti-lastrow:yes'> <td width=103 valign=top style='width:77.4pt;border:solid windowtext 1.0pt; border-top:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>Quality Measures</span></b><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> </td> <td width=134 valign=top style='width:100.35pt;border-top:none;border-left: none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>All Hospital IQR measures and additional measures to be proposed by applicants <o:p></o:p></span></p> </td> <td width=401 colspan=3 valign=top style='width:301.05pt;border-top:none; border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>To be proposed by applicants, but CMS will ultimately establish a standardized set of measures that will be aligned to the greatest extent possible with measures in other CMS programs <o:p></o:p></span></p> </td> </tr> </table> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <p class=MsoNormal align=center style='mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;text-align:center'># # #<span style='font-size:9.0pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p> <p><span style='font-size:9.0pt;font-family:"Arial","sans-serif"'>&nbsp; <o:p></o:p></span></p> <div class=MsoNormal align=center style='text-align:center'><span style='font-size:9.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman"'> <hr<!--/RSS_SECTION--> size=2 width="100%" align=center> </span></div> <p class=MsoNormal><span style='font-size:9.0pt;font-family:"Arial","sans-serif"; 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These features are designed to assist you in obtaining the information you are seeking.&nbsp; <o:p></o:p></span></p> <p class=physicaladdress><!-- BLOGLINK --><!-- SHARE_CONTENT -->Centers for Medicare &amp; Medicaid Services (410-786-5473) · 7500 Security Boulevard · Baltimore MD 21244 </p> <p class=MsoNormal><span style='font-size:9.0pt;font-family:"Arial","sans-serif"; mso-fareast-font-family:"Times New Roman"'><img border=0 width=1 height=1 id="_x0000_i1027" src="http://links.govdelivery.com:80/track?enid=bWFpbGluZ2lkPTE0NDU4NDAmbWVzc2FnZWlkPVBSRC1CVUwtMTQ0NTg0MCZkYXRhYmFzZWlkPTEwMDEmdHlwZT1vcGVuJnNlcmlhbD0xMjc2NjcwMDQwJmVtYWlsaWQ9ZGVib3JhLnBoaWxpcHNAcG9sYXJpcy1ncm91cC5jb20mdXNlcmlkPWRlYm9yYS5waGlsaXBzQHBvbGFyaXMtZ3JvdXAuY29tJmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY=" style='border-style:hidden;border-bottom-width:0in;border-left-width:0in; border-right-width:0in;border-top-width:0in'><o:p></o:p></span></p> </div> </body> </html>