Action News Jax Investigates: Plan to reduce cost of heart surgery

President Barack Obama’s administration said it’s implementing a new health care system to increase quality of care while reducing expenses.

The government is laying out a new payment system for those undergoing heart surgery called “bundled payments.” The purpose is to deliver better care and decrease the cost for providers.

Brooks Rehabilitation in Jacksonville has been a leader in a test program for this payment system.

Action News Jax reporter Kaitlyn Chana asked the U.S. Department of Health and Human Services Secretary, Sylvia Burwell, about the idea. She told us the system will pay hospitals a set amount instead of paying providers for each test or service.

“It leads to care that is based on the outcome for the patient ... in other words, it’s about making sure that what is paid for is a quality outcome for the patient,” Burwell said.

If the hospital meets the target goals and spends less, they keep some of the money. If they spend more than the allotted amount, they have to pay back money to the government.

Health professionals we spoke with say they’re skeptical of the idea. They said switching equipment to reach a smaller price goal may cause additional complications in the operating room. When we asked Burwell this question she said, “They will have a choice and that’s what is important about a bundle approach.”

Some medical staff members said they think the new program will compromise the quality of medical professionals entering the field.

When asked about their fear that doctors and nurses might leave the profession due to the program, Burwell said she thinks this new payment plan will actually excite health professionals, inspiring them to continue to provide the best care.

Burwell said the bundled payments for care improvement is composed of four broadly defined care models. Each bundle payment is for multiple services received during an episode of care.

Traditionally, Medicare separates payments to providers for each service they perform. Now, these services will be combined into a bundled payment.

To learn more, visit the Department of Health and Human Services website.

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