Mount Sinai Hospital takes the lead for the future

Release date

Friday, February 1st 2013

One of only 12 Illinois hospitals named to CMS “bundled care” project

(CHICAGO, February 1, 2013) Mount Sinai Hospital is one of twelve hospitals in Illinois selected by the Centers for Medicare and Medicaid (CMS) to participate in a model project on managing patient care across healthcare providers in order to optimize quality and manage costs. For Mount Sinai Hospital, that means heart failure and chronic obstructive pulmonary disease patients who are seen by physicians in Sinai Medical Group and cared for at Mount Sinai Hospital or Schwab Rehabilitation Hospital. The project is a result of the Bundled Payments for Care Improvement Act, made possible by the Affordable Care Act. Says Sinai President and CEO, Alan Channing, “Participation in this CMS effort is another way Sinai puts patients first and it is consistent with our vision of being the national model for the delivery of urban healthcare.”

The Bundled Payments for Care Improvement initiative includes four models of bundling payments, varying by the types of health care providers involved and the services included in the bundle. Depending on the model type, CMS will bundle payments for services beneficiaries receive during an episode of care, encouraging hospitals, physicians, post-acute facilities, and other providers as applicable to work together to improve health outcomes and lower costs. Organizations of providers participating in the initiative will agree to provide CMS a discount from expected payments for the episode of care, and then the provider partners will work together to reduce readmissions, duplicative care, and complications to lower costs through improvement.

Today’s announcement marks the start of Phase 1 of Models 2, 3, and 4. In Phase 1 (January-July 2013), over 100 participants partnering with over 400 provider organizations, will receive new data from CMS on care patterns and engage in shared learning in how to improve care. Phase 1 participants are generally expected to become participants in Phase 2, in which approved participants opt to take on financial risk for episodes of care starting in July 2013, pending contract finalization and completion of CMS’ standard program integrity reviews.

“The objective of this initiative is to improve the quality of health care delivery for Medicare beneficiaries, while reducing program expenditures, by aligning the financial incentives of all providers,” said CMS Acting Administrator Marilyn Tavenner. ###