AAPM&R: Working Hard for You
Academy Opposes Senate Finance Committee’s Proposed Bundled Payments
On May 15, 2009, the Academy submitted comments to
Senate Finance Committee Chair Max Baucus (D-Mont.) and committee ranking
minority member Charles Grassley (R-Iowa), expressing our concerns relative
to the committee’s description of policy options – Transforming the Health
Care Delivery System: Proposals to Improve Patient Care and Reduce Health
Care Costs. The document is one of a series of health care reform options
papers that provides insight as to how the committee plans to tackle
delivery issues in health care reform legislation during this congressional
session. The Academy specifically addressed the issue of bundled payments
for acute and post-acute hospital care and said that “without any
evidence-based medicine studies to prove that the concept is indeed cost
effective, any bundling proposal should be examined closely, pilot-tested,
and problems should be resolved prior to implementation”. The Academy stated
that the proposals “may negatively impact patients and the quality of care.”
In addition, AAPM&R made the following recommendations to
the committee that must be pursued prior to the implementation of post acute
care bundling:
- Conduct pilot demonstrations of any proposed bundling
method (acute hospital and post acute hospital control of the bundled
payment) and systematically analyze the results of any acute- Post Acute
Care (PAC) bundling experiment prior to its wholesale adoption;
- Complete the PAC Payment Reform Demonstration (PAC-PRD)
project, analyze data from the Continuity Assessment Record & Evaluation
(CARE) tool, and factor these findings into the design and assessment of
bundling; and
- Obtain detailed data on clinical conditions, costs,
access and outcomes for potentially affected patients and post acute care
providers.
To read the Academy’s comment letter,
click here. (PDF Download)
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