May 25, 2021 – Innovatus Health, a wholly-owned subsidiary of Lee Health, achieved $3.1 million in shared savings for first quarter 2020 performance as a participant in the Centers for Medicare and Medicaid (CMS) Bundled Payments for Care Improvement – Advanced program (BPCI-A).
The bundled payments program was created by CMS’ Innovation department to develop new payment and service models to improve how health care is delivered and to lower the cost of care.
Innovatus Health, which is a network of local physicians and providers, delivered care at a cost 19% below the target during the 90-day period of the first quarter of 2020. This was Innovatus’ first time participating in the bundle program and it achieved 95% of the maximum savings possible.
The BPCI-A program “bundles” payments to health care providers for services required to treat conditions, such as congestive heart failure, sepsis or stroke. The care providers then take on the financial risk of the total cost of caring for their patients with these conditions, with the intent of providing quality care at a lower cost. This structure incentivizes physicians to coordinate care, develop innovative care models, improve quality and reduce overall cost to the Medicare program.
Innovatus achieved its cost savings by utilizing robust data analytics, high-risk care management and improved care coordination between primary care physicians, specialty physicians, hospitals, home health agencies and local nursing homes.
“Participation in the bundled payment program provided us with the opportunity to seek innovations in treating Medicare patients. With innovation comes risk, and our physicians and community partners did not shy away from finding improved ways to care for patients in Southwest Florida,” said Kris Fay, chief officer of population health & physician services. “Our Lee Physician Group participants and partner providers were instrumental in achieving these savings while improving the quality of care for our region’s Medicare patients. We look forward to continuing to lead the way in provider-led innovation for Southwest Florida.”
Innovatus’ results in the bundled payment program shows that you can improve the quality of care while lowering the cost. In this case, Innovatus demonstrated:
•improved patient access to care and reduced the average wait time for a physician appointment after a hospital discharge;
•reduced the number of Emergency Department visits; and
•reduced the number of patients who were readmitted after a hospitalization.
A key element of the program’s success is empowering the patient in their own health care by giving them tools to support wellness. Innovatus’ nurses and social workers help patients manage both medical and social needs. This includes arranging for transportation to appointments, providing health education and even sometimes attending physician appointments with the patient.
“Innovative models such as CMS’s bundled payments program is moving the needle in sustainable and effective ways to truly improve outcomes and lower costs significantly,” said Venkat Prasad, M.D., chief medical officer of population health and physician services. “Lee Health is committed to our journey of improving the health of our population and you can expect more successes like this as we move forward.”
About Lee Health
Since the opening of the first hospital in 1916, Lee Health has been a health care leader in Southwest Florida, constantly evolving to meet the needs of the community. A non-profit, integrated health care services organization, Lee Health is committed to the well-being of every individual served, focused on healthy living and maintaining good health. Staffed by caring people, inspiring health, services are conveniently located throughout the community in four acute care hospitals, two specialty hospitals, outpatient centers, walk-in medical centers, primary care and specialty physician practices and other services across the continuum of care. Learn more at www.LeeHealth.org.