MedSolutions chosen for CMS bundled payment program

Cost management company expanding post-acute services, will hire on-site nurses

Health care cost management company MedSolutions has been chosen by the Centers for Medicare and Medicaid Services to participate in a federal bundled payment program, expanding the company's post-acute care management services.

The Bundled Payments for Care Improvement initiative is a payment reform program that seeks to contain CMS reimbursement costs. Through the program, organizations manage an entire care episode and are reimbursed through one bundled payment, rather than via fragmented billing based on individual services.

MedSolutions has recently partnered with 112 hospitals to provide post-acute population health management services through the program, representing a significant shift in the company's business model. The Franklin-based company has previously been hired by insurers to manage utilization costs, but through the new program, MedSolutions will contract with CMS and partner directly with hospitals.

The company plans to hire an unspecified number of nurses to work on site at hospitals as case managers, said Yvonne Daugherty, MedSolutions' vice president of marketing. MedSolutions has committed to cost savings of two percent from discharge to 90 days post-discharge and will be responsible for both risk and reward.

"As the health care system embraces payment reform, bundled payment is likely to play a meaningful role," Curt Thorne (pictured), MedSolutions' president and CEO, said in a statement. "The opportunity to be part of this CMS initiative positions MedSolutions to be a leading innovator in payment reform. It also fulfills a long-term goal for MedSolutions to partner directly with hospital and physicians to improve patient outcomes and reduce costs."

Bundled payment reform is a product of CMS' Innovation Center. The first participating organizations were selected in January 2013 and CMS continues to test the potential for health care savings through various reform models.