Caradigm Solutions for Bundled Payments

Care Management for Bundled Payments for Care Improvement and Comprehensive Care for Joint Replacement

Caradigm Care Management enables providers to succeed under bundled-payment programs such as the Bundled Payments for Care Improvement (BPCI) initiative and the Comprehensive Care for Joint Replacement (CJR) model. Under BPCI, organizations enter into payment arrangements that include financial and performance accountability for episodes of care. BPCI may lead to higher quality and more coordinated care at a lower cost to Medicare. CJR aims to support better and more efficient care for beneficiaries undergoing the most common inpatient surgeries for Medicare beneficiaries: hip and knee replacements. Likewise, CJR tests bundled payment and quality measurement for an episode of care to encourage hospitals, physicians, and post-acute care providers to work together to improve the quality and coordination of care from the initial hospitalization through recovery.

As healthcare organizations seek to earn reimbursements from CMS, they will need new solutions to manage the care and costs of beneficiaries that fall under the programs. Caradigm Care Management enables organizations to flag and follow bundled-payment beneficiaries throughout their episodes of care. Care Management equips a multi-disciplinary care team to provide coordinated care for patients while working at "top of license". It employs evidence-based assessments that auto-generate care plans and recommend mitigations, facilitate medication review and help care managers plan their day and prioritize tasks. Effective and efficient care management coordination can help organizations manage utilization of services, reduce avoidable readmissions and control costs—keys to success under bundled payment programs. Investment in the right care management solution can enable a positive return on the revenue earned through BPCI and CJR.