CMS expects 30% of the referrals to be bundled by mid-2016 and 50% mid-2017 and 100% thereafter. The long term care market has committed more providers to the demonstration projects than hospitals and physician groups but they are the least prepared.  As of yet their software hasn’t been designated as meaningful use for interoperability and standardizing the processes.

The old referral process is gone.   Discharge planners are no longer the point people for your census development. It is the finance department at the hospital or LTCH or the Network.

1. Most referrals are already designated. When approaching discharge referrals are based on contractual commitments between the upstream and downstream providers.
2. Much of the risk taking is handed off. Downstream providers due to the longer lengths of stay and cost will absorb most of the risk.
3. Quantity of referrals is still very important. More referrals and census to capitalize on economies of scale
4. Quality outcomes will be a second thought. Until there is experience with bundling for expanding episodic cases data and metrics becomes golden.
5. Adding bundles will up the ante. CMS will then bundle diabetes, CHF, stroke, cardiac arrest, then complex episodes and outliers carrying more and more risk.

Get out front of your competition get with me for a demo and a plan See www.episodicpricecost.com for details.