Lancaster General Hospital (LGH) is participating in a Medicare initiative called Bundled Payments for Care Improvement initiative. Medicare is using the BPCI initiative to encourage doctors and hospitals to work more closely together to improve patient care. Patients benefit because LGH and its medical staff will have an additional incentive to provide high-quality care with greater efficiency and lower cost. Medicare will monitor the care we provide to make sure patients get high-quality care.
Medicare will make a single payment to LGH for all hospital and doctor services during the patient’s hospital stay and for any re-hospitalizations within 30 days related to the patient’s condition.
BPCI places a greater emphasis on providing the highest quality, cost-effective care. Under traditional fee-for-service payments, hospitals and doctors are rewarded for performing procedures with little or no incentive to coordinate care. When hospitals and doctors share a fixed, lump-sum payment, it encourages collaboration to improve the quality and efficiency of care provided to patients.
Your Medicare benefits are unchanged and not affected by BPCI. You will still have to pay the coinsurance amounts and any applicable deductible for hospital and doctor services. These will be identified in the Medicare Summary Notice you will receive from Medicare, just as they are now.
Our first goal and responsibility is to provide you with high-quality, safe, and effective healthcare. The BPCI Initiative does not change that, nor does it change any of your benefits under Medicare. You retain the right to use any doctor or hospital you choose. What BPCI will do is help LGH and its doctors develop innovative ways to provide high-quality care more efficiently and at lower cost. LGH and its doctors will still be monitored closely to ensure the quality of our care.
Included in the episode of care are services associated with the initial hospitalization provided by surgeons, anesthesiologists, radiologists, consulting physicians and all advanced practice providers; all post-op care, including room and board; all medical and surgical supplies; medications, lab, and X-ray; ancillary services and routine charges and any services associated with a readmission within 30 days of the initial hospitalization.
You have the right to choose which hospital or doctor will deliver your care. If your BPCI- associated procedure has yet to be performed and you wish to not participate in this initiative, you would need to transfer to a non-participating facility. Please discuss this with your doctor first, before considering a transfer.
Find a different hospital by visiting Medicare’s Hospital Compare or find a different doctor with Medicare’s Physician Compare. You can also access these options by calling 800-MEDICARE (800-633-4227). TTY users should call 877-486-2048.