Both the Centers for Medicare and Medicaid Services (CMS) and private insurers are moving toward bundled payments for episodes of care. We believe that the health care industry has an opportunity to make this movement much more effective and useful by drawing on more than 30 years of experience with an earlier form of bundled payment: Diagnosis Related Groups (DRGs), which created a system of fixed payments for inpatient services associated with specific diagnoses and procedures……more

What drives the 5% of patients who cost 50% of healthcare dollars?