53 - Is There Value in Retrospective 90-Day Bundle Payment Models for Cervical Spine Procedures?

Abstract

BACKGROUND CONTEXT: The Centers for Medicare and Medicaid Services (CMS) Bundled Payments for Care Improvement (BPCI) initiative was implemented at our private orthopedic practice in 2015. At that time, we implemented a retrospective payment model 2 for a 90-day episode of care and selected cervical spine and other orthopedic procedures. Under these retrospective payment models, Medicare continues to make fee-for-service (FFS) payments but reconciles the total expenditures for the episode with a bundled payment amount as determined by CMS. A payment or recoupment amount is then made by Medicare reflecting the aggregate expenditures compared to the target price. The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.