Bundling Payments to Promote Integration and Efficiency – Commonwealth Fund – 4 April 2012

Posted on April 24, 2012. Filed under: Chronic Disease Mgmt, Health Economics | Tags: , |

Bundling Payments to Promote Integration and Efficiency – Commonwealth Fund – 4 April 2012

by David Squires

“High-quality care for patients with chronic and complex conditions often involves coordinating between multiple providers and sources of care. Fee-for-service payment, which reimburses providers for a particular service, fails to provide incentives to coordinate care and can encourage providers to work in silos. Bundled payments—also known as episode-based payment or case rates—have been proposed as a way to encourage coordination across providers and to promote more efficient care. Under a bundled payment, a single fee is paid for an entire episode of care; for example, a single fee for hip replacement would cover both the procedure itself and the rehabilitation and follow-up treatments. This fee would be divided among the providers along the care pathway, either prospectively or retroactively.

Bundled payments already exist in the U.S. in a number of systems, such as the Geisinger Health System. The Affordable Care Act contains provisions advancing bundled payments in Medicare, including a large-scale pilot scheduled to be rolled out by January 1, 2013. Other countries have also experimented with bundled payments, most notably the Netherlands and Germany. Their experiences can inform U.S. efforts to reform health system payment and drive improvement.”

… continues on the site

Looks at:
Bundling Payments for Chronic Conditions in the Netherlands
Integrated Care Contracts in Germany


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