Program Stewardship
Adopting healthcare bundled payments to improve quality & reduce costs
The Client
A major healthcare subsidiary company that provides an array of clinical professionals and integrated technologies delivering a mobile integrated healthcare framework for distributing value-based care to individuals and populations.
The Challenge
The client elected to participate in the Centers for Medicare & Medicare Services (CMS) Bundled Payments for Care Improvement (BPCI) initiative to test innovative payment and service delivery models. These models had the potential to reduce Medicare, Medicaid, or Children’s Health Insurance Program (CHIP) expenditures while preserving or enhancing the quality of care for beneficiaries. The client’s goal was to implement Bundled Payments at 40 sites across 11 states. A program manager and an IT project manager from Dietrich partnered with the Chief Quality & Medical Officer to provide national program leadership and drive the IT integration for the multi-year BPCI program.
The Approach
Working closely with senior leadership, Dietrich:
- Led the integration across various settings and regions in preparation for BPCI launch.
- Designed, developed and implemented the plan for the BPCI IT solution that integrated data between multiple systems and ensured consistency between clinical integration and IT integration.
- Managed the overall project implementation ensuring coordination of activities, continual communication and status reporting, oversight of testing strategies, and training of new responsibilities.
- Established effective working relationships with hospitalists, site administrators, business unit leadership, and technology leadership.
- Increased revenue by executing a multi-phased implementation plan that increased capabilities and processes over time.
- Improved quality by providing education and outreach to hospital systems, individual hospitals, and physician practice groups.
The Result
The client achieved their vision and delivered on the promise to reduce healthcare costs and improve the quality of care across the United States due to the BPCI implementation. Revenue increased while clients decreased operating costs by more than 10% and reduced preventable emergency room and/or unnecessary Emergency Department visits by as much as 50%. At the same time, overall patient satisfaction improved. By implementing the BPCI integrated IT solution, the client gained extraordinary positioning as a leading national healthcare company. The implementation of people, process and technology infrastructure paved the way for an annual fee for service revenue growth of up to $5M per hospital.