At the end of2014, the medical device industry took another step forward in the healthcare accountability movement when a number of companies announced plans to take on performance-based financial risk on implants.
Stryker Performance Solutions, however, has taken an even more comprehensive approach to risk-based partnerships with our clients. Stryker's relationships with its Bundled Payment for Care Improvement clients has evolved beyond just consulting; we have launched risk based contracts so that our fees are tied to overall patient outcomes, quality improvement, and cost reduction, rather than device performance. Stryker truly partners with our clients to improve patient care and participate in payment reform.
Here are some of Stryker Performance Solutions' commitments to its clients:
- BPCI Annual Technical Data Support
- Episode Database—analyze monthly claim files, link claims into episodes based on BPCI episode logic rules including readmissions, remove unrelated claims, apply proration methodology and store relevant data elements for analysis.
- Monthly/Quarterly Analysis—prepare monthly reports and quarterly analysis of results identifying reasons for variation while monitoring physician and facility results compared to base period and benchmarks.
- Reconciliation Analysis—review CMS reconciliation results and verify compared to monthly claims analysis. Work directly with CMS to resolve any issues and identify inaccuracies.
- Gain Sharing Calculations
- Implementation Support
- Assist with finalizing and operationalizing the Implementation Protocol and other BPCI program documents required by CMS.
- Lead and manage all CMS interactions related to BPCI (to the extent allowed by CMS).
- Support the creation and implementation of client’s care re-design and quality improvement efforts relating to BPCI, including organizing and leading monthly phone meetings and onsite meetings as needed with the various steering committees.
- Support the creation and implementation of client’s gainsharing arrangements, including contract templates.
- Assist in developing template reports for reporting required data to CMS and for tracking performance on various metrics for performance improvement, gainsharing and related purposes.
In lieu of the traditional cash fee payment for the services described above, our customers pay Stryker Performance Solutions a savings percentage of the total Net Payment Reconciliation Amount (NPRA) determined by CMS under the BPCI program. In short, if their customers do not succeed then they do not get paid. Unlike competitors, success is not just dependent on the performance of one implant, but entire episodes of care, service lines or even health systems. Navigating the rapid shift away from traditional fee-for-service payment models toward value- and risk-based contracting can be intimidating. Stryker Performance Solutions can help you decide when to begin the process of analyzing and adopting these new payment models and then truly partner with you to successfully implement, manage, and scale them.