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Under health reform, hospitals and physicians need to be ready for bundled payment methodologies. Bundling payments is CMS’s preferred payment methodology and appeals to payers in general because of its transparency, elimination of variances, shifting of risk, and manner in which it aligns hospital and physician incentives. TRG can ensure your preparedness for both Medicare and non-Medicare bundled payments and help you gain market share by developing a bundled price proposal. We have successfully marketed bundled payments to self-funded corporations, managed care networks and Medicare.
TRG’s Bundled Payment Experience
The consultants of TRG have more Bundled Payment experience than anyone else in the U.S. Over the last 15 years, our principals have constructed hundreds of Bundled Payment packages for both Medicare and non-Medicare payers. We have successfully marketed bundled payments to self-funded corporations, managed care networks and Medicare. The principals of TRG have participated in five Medicare Bundling Demonstrations and TRG is the only consulting firm to assist all five of the current CMS Acute Care Episode “ACE” Demonstration sites.
Our services include:
- Hospital-physician bundled payment development
- Completion of CMS application and proposal submission
- Benchmarking of bundled payment splits
- Financial impact modeling including market opportunity and efficiency analysis
- Gainsharing development
- Billing and payment algorithm and process development
- Patient identification systems development
- Marketing and public relations plan development
- Physician and practice management education
- Hospital staff education
- Payer and employer targeting and marketing
With health care reform here, hospitals and physicians need to begin preparing for bundled payment methodologies. TRG can ensure your preparedness for both Medicare and non-Medicare bundled payments AND help you gain market share in the meantime by developing a bundled payment proposal for non-Medicare payers.
TRG’s Bundled Payment Approach
TRG assists hospitals and physicians in developing Bundled Payment packages for CMS demonstrations AND non-Medicare payers.
TRG’s approach includes:
- Serving as the facilitator and intermediary between hospital, physician and post-acute providers;
- Determining episodes to be included in bundled package;
- Utilizing physician-provided claims data or preparing an actuarial estimate for physician component;
- Consulting pool and outlier methodology development;
- Profitability and breakeven analysis to assess bottom line impact;
- Development of operational patient identification, tracking and payment system;
- Development of participating physician agreements and terms; and
- Identifying and marketing to self-funded employers and commercial payers.
Our proven process is typically four months:
Targeting and Presentations
Be a leader in your market with bundled payments. The benefits include:
- Increased market share
- Create greater alignment between hospital and physician partners
- Gain valuable experience for CMS national roll-out of bundled payments
To learn more about TRG’s Bundled Payment services, please email email@example.com or call 303-300-5251.