5 Questions to ask when choosing a Medicare convener - TRIARQ Health

Medicare has opened applications for Bundled Payment for Care Improvement Advanced (BPCI-Advanced) for 2024 and 2025. Many Orthopedic surgeons are pondering whether or not their participation in this program is “worth it.” General frustration abounds from some providers who have previously participated in BPCI. There are differing opinions about the success of the bundle payment program, and many providers and practice leaders have more questions than answers about this value-based care program.

Orthopedic providers may not realize that not all Medicare conveners are the same and that which convener you choose can affect your bottom line. With some due diligence, orthopedic practice leadership can ensure that they select the right Medicare convener for their practice.

To understand what you should expect from your next Medicare convener, here are five questions to ask yourself:

• Does your Medicare convener work alongside you and your office staff to develop innovative patient care methods?
• Does your Medicare convener document efficient and effective care plans and clinical pathways to share with your referral partners and office staff?
• Does your Medicare convener have the in-house expertise to show you where and how your practice staff can operate more efficiently?
• Does your Medicare convener show how to select referral partners committed to the same clinical outcomes you are?
• Does your Medicare convener provide data, reports, and actionable insights about your patients’ actual post-acute care cost?

If you said no to any of the above questions, you might want to explore working with a new Medicare convener.

Essential tools and services that your Medicare convener should provide your practice:

• A hyper-local clinically integrated network developed based on actual performance data.
• Proven care paths and clinical pathways that improve the patient’s experience and clinical outcomes.
• Quarterly review sessions with value-based care experts who can help you understand where there may be ways to achieve greater efficiencies and remove barriers to care.
• Insights into what data your payers and other care partners are looking at and what this information tells them about your practice.

TRIARQ Health has been a Medicare convener since the beginning of BPCI-A. We provide the above support, service, and expertise to provider practices that partner with us in the bundled payment program. Our success as a convener is rooted in the fact that we seek to simplify the connections between providers, payers, and patients and make it easier for physicians to practice medicine.

TRIARQ Health is more than a risk-bearing entity and Medicare convener. Our company has been in business for nearly twenty years, and we understand the business side of health care. We know what it costs, and we understand how payers work. The physician practice services division of TRIARQ Health provides industry expertise and technology solutions to independent practices that want to operate more efficiently and improve their financial performance regardless of their participation in bundled payment programs.

Contact us today to find out if we are the right Medicare convener for your practice.