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Bundling Payments

Background

A large orthopedic group was bundling their payments for certain procedures in their medicare and commercial populations. The group’s engagement included all care before and up to 90 days post visit. They had begun rapidly increasing market share in both populations and procedures. As a result, their existing billing technology, including patient tracking, became increasingly inadequate as they tried to meet future program needs and goals.

Solution

Element partnered with the clinicians and financial operators to create a technology workflow highlighting best practices throughout the entire patient bundled procedure. This included pre-assessments, patient intervention worklists and advanced reporting. The technology includes easy to access tracking and required touchpoints by Medicare. Element consultants partnered with clinicians to leverage their best practice for patient optimization on every bundled patient.

Results

Implemented care management documentation, worklist and risk assessment tool. Tool links clinical data and financial outcomes for each bundled procedure. Driving users to proactively make clinical interventions during entire episode for only value driving activities. The technology was found to be so helpful, it was created for Medicare, commercial and combination Medicare/commercial patient populations.