Efforts to change the way healthcare providers are compensated in the U.S. from fee-for-service to payment for a bundled set of services are well underway according to a new study released at the National Bundled Payment Summit. The independent research also found that payment reform requires the adoption of new operating platforms that were not previously used by health plans and that providers can band together to accept financial risk and improve their collective performance. The research was commissioned by the non-profit Health Care Incentives Improvement Institute™, Inc. (HCI3™) and conducted by Bailit Health Purchasing, LLC.
“This report updates our research from last year and shows that innovation is continuing to progress in bundled payment pilots,” said Francois de Brantes, executive director for HCI3. “In addition, early adopters such as Horizon Healthcare Services and Blue Cross Blue Shield of North Carolina are now moving to fully scaled implementations and making bundled payments a core provider reimbursement strategy.”
Those using bundled payment in a similar study from last year and still doing so, have broadened the application. While some early commercial-sector adopters have abandoned the payment methodology, other payors and providers in both the public and commercial sectors are making bundled payments part of their permanent reimbursement strategy.
At the same time, certain challenges continue to plague bundled payment efforts, including a lack of data, lack of engaged leadership, lack of resources to implement alternative payment methodologies and lack of engagement in local efforts by national plans. However, these challenges are no different than those affecting alternative payment reform efforts across the country.
“Select private and public payors across the U.S. are making a significant commitment to employing bundled payment as a high priority purchasing strategy,” said Michael Bailit, president of Bailit Health Purchasing and study author. “They are committed to reforming payment in order to reduce waste and improve quality. We will continue to have much to learn from their experiences as their efforts progress.”
Source: Health Care Incentives Improvement Institute, June 11, 2013
Blueprint for Bundled Payments: Strategies for Payors and Providers provides perspectives on payment bundling, including definitions of key elements, advice for payors and providers, and examples of the payment model at work in one organization.