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Yes.
Bundling of payments will happen, along with other “modernized approaches to payment”, as deemed appropriate by the Commissioner . Sec 224, pg 125 specifically includes:
Patient centered medical home: a previous section defines this as a capitated health care system with a once-monthly payment to the central provider who may be a “physician or other provider”. This is HMO-type capitation run with gov’t bureaucratic efficiency, apparently allowing NPs to be directly responsible for directing patient care without physician supervision. I assume this is a change from the current system. I think there is a requirement for physician supervision currently, but not sure. Does anyone know?
Accountable care organizations: These are defined as groups of “physicians or other providers” who care for patient groups. Essentially another capitated payment structure.
Value-based purchasing
Bundling of services. Nothing more specific on this. The current ACES trial for Medicare will run for 18 months as a trial for this scheme which is another capitation scheme for inpatient services. Keep in mind that in this model, the more a prosthesis costs, the less pay available for the surgeon and other providers.
performance or utilization based payments, partial capitation, and direct contracting with providers.
