Published on February 11, 2013

Bundled payments could offer $5 million boost for St. Vincent's

By Ashley Gurbal KritzerReporter- Jacksonville Business Journal

St. Vincent’s Health Care could see a boost of more than $5 million from participating in the Centers for Medicare & Medicaid Services’ bundled payment initiative.

The hospital will participate in three diagnosis-related groups: Total joint replacement, spinal surgery and congestive heart failure, meaning that it will charge one flat, negotiated fee for those procedures and treatments instead of charging patients and Medicaid and Medicare individually for each service involved in the procedure.

Bundled payments are part of the new approach to health care outlined under the Affordable Care Act: Move away from a fee-for-service-based system and adopt a payment model that rewards providers for quality care instead of volume.

If St. Vincent’s can provide care for patients in those DRGs for less than the federal government’s estimates, it gets to retain a large share of the savings.

The hospital is one of 500 providers approved to participate in the bundled payment initiatives, and CEO Moody Chisholm previously told the Business Journal that the hospital had spent $400,000 on the application to the program alone.

Chisholm said Monday that the program is in its trial phases. He doesn’t know when the program will officially start, how often his hospital will receive payments on savings generated under the initiative or have to make payments to the government if the hospital falls short of the projections.

“When we look at what the costs are in the entire episode of care, we can identify things we think are opportunity,” Chisholm said. “If it’s not at least $5 million in savings that we can generate, I’d be disappointed.”

Read the article in the Jacksonville Business Journal