RLI On Demand

June 2020: Understanding Bundles of Care Payment Models from Multiple Perspectives




Moderator: Geoffrey Rubin, MD, MBA, FACR & Kathleen Blake, MD
Faculty: Kevin Bozic, MD, MBA, Richard Duszak, MD, FACR, Patrick Hammond, Michael Suk, MD, JD, MPH, FACS, Christine Ritter, PhD


Description: RLI & AMA come together to present Understanding Bundles of Care Payment Models. As the Centers for Medicare and Medicaid moves towards using bundle care packages, department chairs must understand the revenue distributions and be prepared to advocate for their fair share of the pie. A panel of experts representing the various stakeholders has been assembled to discuss the various sides and how everyone must come together to make these bundles most effective.

Learning Objectives


At the conclusion of this webinar, participants will be able to:

  • Describe the history of bundled payments in the United States
  • Define the role that physicians play in guiding the design of care bundles
  • Identify the perspectives of key stakeholders in defining care bundles
  • Develop an approach to considering payer versus provider initiated bundles

Recorded Webinar


Faculty Bios


 Moderators  
Image of Dr. Blake Kathleen Blake, MD, MPH is Vice President, Healthcare Quality at the American Medical Association where she leads payment and quality initiatives of the AMA’s Professional Satisfaction and Practice Sustainability strategic focus initiative. Her team focuses on the impact of new payment models and coding requirements on practices, the characteristics of high performing practices, and the integration of behavioral health care into practice. From 2013 until 2016, she was executive director of the PCPI®, which includes the National Quality Registry Network™. Dr. Blake was co-chair of the Health Information Technology Policy Committee of the Office of the National Coordinator for Health Information Technology until April 2017. She is a member and treasurer of the Governing Committee of the National Evaluation System for health Technology (NEST) coordinating center, a public private partnership advancing innovation and use of real-world evidence throughout the total product life cycle of medical devices. She is an AMA subject matter expert on a wide range of health technology innovations including artificial intelligence, terminology, clinical registries, appropriate use criteria and clinical decision support tools.

Dr. Blake is a clinical cardiac electrophysiologist who received her education and training from the University of Chicago, Stanford University and the Johns Hopkins Bloomberg School of Public Health. From 1988 until 2011, Dr. Blake practiced at the New Mexico Heart Institute, where she also served as President. She is a part-time member of the Johns Hopkins University medical faculty.
Geoffrey D. Rubin, MD, MBA, FACR

Geoffrey D. Rubin, MD, MBA, FACR is the George B. Geller Distinguished Professor of Radiology and Bioengineering at Duke University, where his academic and clinical activities focus on cardiovascular imaging and volumetric image analysis. He currently is the Board Chair of the International Society for Computed Tomography, Board Member of RAD-AID International, founding Board Member of the Radiology Leadership Institute of the American College of Radiology, Member of the Imaging Advisory Board for General Electric Healthcare, and is the Clinical co-Founder of Informatics in Context.

He served as Chairman of the Department of Radiology at Duke University from 2010-2013. Prior to Duke, he was Professor of Radiology at Stanford University from 1993-2010, serving as Associate Dean for Clinical Affairs in the School of Medicine and Associate Director of the Stanford Cardiovascular Institute from 2005-2010, Chief of Cardiovascular Imaging from 2000-2010, and was elected Vice Chief of Staff by the medical staff of Stanford Hospital and Clinics, serving from 2007-2010. He is Past President of the North American Society for Cardiovascular Imagers, the Society for Computed Body Tomography and Magnetic Resonance, and the Fleischner Society for Thoracic Imaging and Diagnosis.

He is an active public speaker, having made over 1000 presentations to medical, scientific, and lay audiences in over 40 countries.

   
 Panelists  
Image of Dr. Bozic

Kevin J. Bozic, MD, MBA is the inaugural Chair of Surgery and Perioperative Care at the Dell Medical School at UT Austin. He is a nationally recognized leader in orthopaedic surgery and value-based health care payment and delivery models. Prior to joining the Dell Medical School, he was the William R. Murray Endowed Professor and Vice Chair of Orthopaedic Surgery at the University of California San Francisco (UCSF) School of Medicine, and Core Faculty of the Philip R. Lee Institute for Health Policy Studies. He holds a Bachelor of Science degree in Biomedical Engineering from Duke University, where he graduated magna cum laude, and an MD with Thesis degree from UCSF. He completed his Orthopaedic Surgery Residency training in the Harvard Combined Orthopaedic Residency Program, and additional Fellowship training in Adult Reconstructive Surgery from Rush University Medical Center in Chicago. Dr. Bozic also holds a Masters of Business Administration from Harvard Business School (HBS), where he continues to serve as a Senior Institute Associate in Professor Michael Porter’s Institute for Strategy and Competitiveness.

Dr. Bozic’s clinical practice is focused on the management of patients with hip and knee arthritis and painful hip and knee arthroplasties, which he does in collaboration with a multi-disciplinary team of providers focused on improving health outcomes that matter to their patients, including pain, function, and quality of life. He has over 17 years of experience as an Adult Reconstructive Surgeon focusing on simple and complex primary and revision hip and knee arthroplasty.

Dr. Bozic has extensive research and policy experience in the field of value-based health care, focused on implementation and evaluation of value-based payment and delivery models. His research has been funded by the Agency for Health Care Research & Quality (AHRQ), the National Institutes for Health (NIH), and the Robert Wood Johnson Foundation (RWJ). He is actively involved in numerous regional and national health policy initiatives, including Chair of the American Joint Replacement Registry; the Yale Center for Outcomes Research & Evaluation (CORE) Performance Measurement Group; and the Health Care Payment Learning Action Network (HCP-LAN). He is the co-founder and former Chair of the California Joint Replacement Registry, past Chair of the American Academy of Orthopaedic Surgeons Council on Research and Quality, and a former member of the Agency for Health Care Research & Quality Effective Health Care Stakeholder Group.

Dr. Bozic has been the recipient of numerous Awards, including the UCSF Exceptional Physician of the Year Award; the Orthopaedic Research & Education Foundation Clinical Research Award; the American Bone & Joint Surgeons Marshall Urist Young Investigator Award; the American Association of Hip & Knee Surgeons James A Rand Young Investigator Award and Lawrence D. Dorr Award; the American Orthopaedic Association American-British-Canadian Exchange and North American Traveling Fellowships; the Orthopaedic Research Society William Harris Award; and the Hip Society John Charnley Award, among others.

Image of Dr. Ritter Christina Smith Ritter, PhD joined CMMI in April 2016 as the Director of the Patient Care Models Group (PCMG). As the Director of PCMG, Chris manages episode and bundle model development and implementation. PCMG’s model portfolio includes the Bundled Payments for Care Initiative, Comprehensive Care for Joint Replacement, Oncology Care Model, Home Health Value Based Purchasing, Medicare Care Choices Model, and the proposed Radiation Oncology Model. Chris has worked in many capacities at CMS in her career. Most recently she was the Deputy Director of the Hospital and Ambulatory Policy Group (HAPG), which handles Fee-for-Service (FFS) payment policy for hospitals, physicians, Part B drugs, and laboratories, among others. Chris previously led payment policy for both the hospital outpatient prospective payment system and the physician fee schedule. In addition to FFS payment policy, Chris also has spent time working on coverage, Medicare Advantage quality measures, and the Medicare Drug Card program, a precursor to Part D drug payment.
Image of Dr. Duszak

Richard Duszak, MD is Professor and Vice Chair for Health Policy and Practice in the Department of Radiology and Imaging Sciences at Emory University.

Currently Council Speaker and a member of the Executive Committee of the Board of Chancellors of the American College of Radiology, Dr. Duszak is an outspoken supporter of evidence-based policy and longtime leader in physician payment policy development. A former three-term member of the Executive Committee of the CPT Editorial Panel, he has served and continues to serve on the editorial boards of several medical journals as well as a daily metropolitan newspaper.

Recently recognized by the Academy for Radiology and Biomedical Imaging Research with its Distinguished Investigator Award and the readers of Aunt Minnie as the nation’s most influential radiology researcher, Duszak has been honored as a fellow of the American College of Radiology, a fellow of the Society of Interventional Radiology, and as the first ever physician fellow of the Radiology Business Management Association. His scholarly pursuits focus on health policy (particularly it pertains to medical imaging access, utilization, and payment systems) and practice management. He has authored over 300 publications and delivered over 500 invited lectures on these topics.

Prior to joining the faculty at Emory, Duszak served as Founding Chief Executive Officer of the Harvey L. Neiman Health Policy Institute and he continues to work closely with the Institute. He previously spent nearly two decades in private practice, where he served as president of a large radiology group in his home state of Pennsylvania.

Follow him on Twitter: @RichDuszak

Image of Dr. Hammond

Patrick Hammond joined Emory Healthcare in 1991 as an Administrative Resident. He is now a member of the Emory Healthcare Executive Leadership Team.

As Chief Executive Officer of the Emory Healthcare Network, he has leadership responsibility for Emory’s Clinically Integrated Network. As Chief Market Services Officer, he is responsible for managed care; market development, and outreach strategies; credentialing, enrollment and medical staff support; data analytics and market research.

Mr. Hammond is a graduate of Emory University where he received a Bachelor of Arts Degree. In 1991 he received a Master of Health Administration from Duke University.

Image of Dr. Suk  Michael Suk, MD, JD, MPH, MBA, FACS is System Wide Chair of the Geisinger Musculoskeletal Institute for the Geisinger Health System and Professor of Orthopaedic Surgery at the Commonwealth Medical College. Selected to lead the Department of Orthopaedic Surgery in 2012, Dr. Suk became one of the youngest persons to head an academic orthopaedic department in the United States. Beginning with 2 main hospital centers and 22 orthopaedic surgeons, over the past 7 years Dr. Suk has overseen the tremendous programmatic growth at 13 diverse hospital platforms including 1 Level I and 3 level II trauma centers representing over 100 employed and non-employed surgeons. As the clinical driving force behind the Geisinger ProvenCare® Acute Orthopaedic Programs in Total Hip, Total Knee, Hip Fracture and Lumbar Spine – Dr. Suk is widely sought after for his expertise in new models for healthcare payment and delivery, physician engagement and leadership. In 2018, Dr. Suk disrupted the dialogue on value-based care by developing and offering the world’s first “lifetime warranty” agreement for total hip replacement and has now extended that to include primary and revision total knee replacements.

Dr. Suk helped lead the effort to transform Geisinger’s care delivery approach away from compartmentalized “service lines” and toward an “Institute” model centered around patient convenience and meeting the highest expectations. In 2015, Dr. Suk was named Chief Physician Officer of Geisinger System Services – to provide clinical leadership over supply chain, facilities management and care support services.

Dr. Suk is an accomplished leader in organized medicine and in promoting patient safety and quality achieving distinction as the first medical student and first Asian-American to be directly elected to the Board of Trustees of the American Medical Association in 1994. In 2016, Dr. Suk was appointed to the American Medical Political Action Committee Board of Directors – spearheading advocacy for the entire medical profession in Washington, DC. That year, Dr. Suk was also named a Baldrige Executive Fellow for performance excellence. In 2019, Dr. Suk was again elected to the AMA Board of Trustees and subsequently named to the Board of the Joint Commission.

Before joining Geisinger, Dr. Suk was associate professor of orthopaedic surgery at the University of Florida–Shands Medical Center, where he served as division chief of Orthopaedic Trauma and as associate director of its Regional Trauma System and its Orthopaedic Residency Program. There, he established a specialized orthopaedic trauma division focused on efficiency and enhancing patient outcomes.

Dr. Suk serves on the editorial board for several orthopaedic journals and has authored numerous articles and a landmark orthopaedic textbook. His work on the link between patient expectations and clinical outcomes in orthopaedic trauma surgery has gained worldwide attention. He speaks internationally on orthopaedic fracture management, healthcare literacy, access and delivery; and the interface between law and medicine.

Dr. Suk simultaneously completed an M.D. at the University of Illinois College of Medicine and a J.D./M.P.H. with special certification in health care law at Boston University School of Law and School of Public Health. He later completed his orthopaedic surgery residency training at Montefiore Medical Center, Albert Einstein College of Medicine and a fellowship in orthopaedic trauma at the Hospital for Special Surgery, Weill College of Medicine at Cornell University. Dr. Suk completed his M.B.A. from the Kania School of Management at the University of Scranton.

                                   

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