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Benchmarking Bundled Payments: Medicare PAC Utilization Benchmarks 
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The Center for Medicare and Medicaid Innovation (CMMI) launched the Bundled Payment for Care Improvement Initiative (BPCI) with more than 150 awardees going live in October 2013 or January 2014. These organizations selected from the 48 family/episode option made up from 179 "anchor" DRGs, and many are adding more episodes to their initial selections. Many more organizations have recently received data to let them analyze joining the program with a January 1, 2015 start.

The opportunity to reduce Medicare claims costs is typically in the post-acute care (PAC) period. Analyzing the opportunity to reduce Medicare PAC spending requires providers to adopt a payor state of mind, with payor tools and approaches being very helpful. Benchmarking to best practices is one of those tools.

Milliman has developed nationwide average and well-managed benchmarks for PAC periods of 1-30, 31-60 and 61-90 days. These benchmarks include the percent of each DRG with use of each service and for all, except home care, the average number of days these services were used: readmissions; long-term acute care, inpatient rehabilitation, SNF, and home care.

During this presentation, examples are provided of PAC benchmarks for selected DRGs to highlight the importance to BPCI awardees of benchmarking claims data experience in order to select episodes; set targets for utilization reduction of relevant PAC services; establish programs to more efficiently manage the utilization of key PAC services; and monitor performance toward targets.

Please join us Thursday, November 13th, 2014 at 2:00 PM Eastern as Milliman's Kate Fitch conducts an expert, in-depth session on Medicare Bundled Payment PAC Utilization Benchmarking.
Learning Objectives
Participants will be able to:
  1. Understand the basic structure and background of the Bundled Payment for Care Improvement Initiative (BPCI)
  2. Consider the approaches to reducing Medicare PAC spending, including benchmarking to best practices
  3. Examine the components and methodology deployed in development of benchmarks for applicable PAC periods
  4. Explore examples of PAC benchmarks for selected DRGs
  5. Ascertain the importance of benchmarking claims data experience in order to select episodes; set targets for utilization reduction of relevant PAC services; establish programs to more efficiently manage the utilization of key PAC services; and monitor performance toward targets
  6. Engage in interactive learning through online question submission, attendee feedback and opportunity for follow up questions, and networking with attendees, faculty and other professionals through dedicated LinkedIn group
Who Should Attend

Interested attendees would include:

  • C-Suite Executives
  • Medical Directors
  • Provider Contracting Executives and Staff
  • Care Management Executives and Staff
  • Case Management Executives and Staff
  • Nursing Executives
  • Discharge Planning Managers
  • Managed Care Executives and Staff
  • Service Line Executives
  • Quality Improvement Executives
  • Network Management Executives and Staff
  • Analytics Executives and Staff
  • Innovation and Transformation Executives and Staff
  • Strategy and Planning Executives and Staff
  • Business Intelligence Staff
  • Managed Care Executives and Staff
  • Other Interested Parties

Attendees would represent organizations including:

  • Hospitals and Health Systems
  • Post-Acute Providers 
  • Physician Organizations
  • Provider Networks
  • Care Management Organizations
  • Health Plans
  • Pharmaceutical Organizations
  • Government
  • Solutions Providers 
  • Associations, Institutes and Research Organizations 
  • Media
  • Other Interested Organizations
Benchmarking Bundled Payments: Medicare PAC Utilization Benchmarks 
  Individual Registration Fee: $195. Downloadable webinar post event materials with video syncing slides and recorded audio: $45 for attendees; $260 for non-attendees after the event. Register online or download the event brochure. Attendees will also receive a complimentary trial three-month subscription to Readmissions News.
Register Now   Corporate Site licensing also available. Click here to register or call 209.577.4888 We look forward to your participation in this event!
Kate Fitch

Kathryn V. Fitch,
RN, MEd, Principal, Healthcare Management Consultant, Milliman

  Kate is a principal and healthcare management consultant in the New York office of Milliman. She joined the firm in 1999. Kate's expertise is in the intersection of benefit design, disease processes, financing health benefits, and managing care. She leads teams of actuaries, benefits consultants, clinicians, and data analysts in projects for disease-management companies, hospitals, employers, HMOs, pharmaceutical companies, and healthcare industry trade organizations. As project lead, she is instrumental in designing data analytics and communicating the implications for clients, as well as managing Milliman resources.

Kate leads projects that require analyzing quantitative and financial outcomes of benefit designs, therapies, processes, and care management, and converting these findings into measurable improvements in quality and financial outcomes. Kate's role typically includes promoting these findings in organizations through reengineering, training, and process improvement. Recent projects have included helping employers and payers evaluate disease management, wellness, and other vendors; groundbreaking work on value-based benefit design; the impact on employers of population-based cardiovascular risk programs; health plan medical management program assessments and redesigns; and inpatient process improvement at several hospitals focused on improved denial management and length-of-stay reduction.

Prior to joining Milliman, she worked for a case-management company, where she developed the company's case manager training and education program. Kate was previously an instructor in the nursing program at Columbia University School of Nursing. Prior to that, she was a research assistant at Memorial Sloane Kettering, where she was involved in nursing research studies. She also worked as a research assistant in pharmaceutical research studies at Roosevelt Hospital. Kate's clinical background includes extensive experience as a registered nurse in emergency, adult inpatient, and ambulatory care units.

Kate is a member, ERISA Industry Committee (ERIC), health policy committee; and serves on the Patient Care Primary Care Collaborative. She received her BSN at Villanova University and her MA, MEd at Columbia University.
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