A New Care Improvement Initiative from Medicare
Questions or Concerns?
Please contact Lancaster General Health at (888) LGH-INFO or info@LGHealth.org
In 2014, Lancaster General Hospital (LGH) began participating in a Medicare initiative called Bundled Payments for Care Improvement (“BPCI”). This participation means that LGH voluntarily agreed to partner with physicians on a new payment initiative with the goal of providing high-quality, efficient, and more-coordinated care.
This initiative only is relevant for Medicare patients undergoing one of the following procedures as part of a hospital stay:
Coronary Artery Bypass Grafting (CABG surgery)
Coronary Artery Angioplasty and/or Stenting
Bundled Payments for Care Improvement aims to help deliver better care
Medicare is using the BPCI initiative to provide doctors and hospitals with increased opportunities to take the quality and efficiency of care to the highest level possible. By working more closely together on planning and delivering care, we anticipate that we can remove inefficiency and waste from our care delivery processes and in doing so lower the costs of care to Medicare.
The focus of this initiative is to increase quality and coordination of care. Hospitals, doctors, and other healthcare providers that deliver care during and after a hospital stay may be rewarded for providing high-quality, more-coordinated care. Medicare will monitor our care and the hospital and physicians’ performance to assure that quality is being increased.
Medicare will make a single payment to LGH for all hospital and doctor services during a patient’s hospital stay and for any rehospitalizations related to the patient’s condition that happen within 30 days after that hospital stay. Patients are still responsible for the coinsurance amounts and any applicable deductible for the hospital and doctors’ services.
It’s a patient’s choice which hospital or doctor they use
Patients continue to have the right to choose which hospital or doctor will deliver their care. If their BPCI-associated procedure has yet to be performed and they wish to not participate in this initiative, patients would need to transfer to a non-participating facility. Patients should discuss this with your doctor first, before considering a transfer.
To find a different hospital, visit www.hospitalcompare.hhs.gov or call (800) MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
To find a different doctor, visit Medicare’s Physician Compare website, www.medicare.gov/physiciancompare, or call (800) MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
For more information
If you have concerns, complaints or questions about Bundled Payments for Care Improvement, ask your physician, call Lancaster General Hospital at (888) LGH-INFO or call (800) MEDICARE. You can also find additional information at www.innovation.cms.gov.