Bundled payments: a glimpse into the future?

As part of its mission to cut costs and improve quality, the Centers for Medicare & Medicaid Services (CMS) has launched a pilot project that pays a fixed price for health services by multiple providers over a period of time. Case managers need to make sure that the care patients receive in the hospital is appropriate and can't be provided in another, less costly and less restrictive setting. Hospitals are going to have to evaluate their current practice patterns to identify potential areas for improvement and adopt the most efficient practices. Case managers must have accurate information about patients and their benefits to create the most appropriate and cost-effective discharge plan.