Bundled payment

Bundled payment is the reimbursement of health care providers (such as hospitals and physicians) "on the basis of expected costs for clinically-defined episodes of care."[1][2][3][4][5] It has been described as "a middle ground" between fee-for-service reimbursement (in which providers are paid for each service rendered to a patient) and capitation (in which providers are paid a "lump sum" per patient regardless of how many services the patient receives), given that risk is shared between payer and provider.[6] Bundled payments have been proposed in the health care reform debate in the United States as a strategy for reducing health care costs, especially during the Obama administration (2009–2016).[7] Commercial payers have shown interest in bundled payments in order to reduce costs.[8] In 2012, it was estimated that approximately one-third of the United States healthcare reimbursement used bundled methodology.[9]

  1. ^ Cromwell J, Dayhoff DA, Thoumaian AH (1997). "Cost savings and physician responses to global bundled payments for Medicare heart bypass surgery". Health Care Financ Rev. 19 (1): 41–57. PMC 4194487. PMID 10180001.
  2. ^ Miller J (1 June 2008). "Package pricing: Geisinger's new model holds the promise of aligning payment with optimal care". Managed Healthcare Executive. Archived from the original on 2010-10-01. Retrieved 2010-03-11.
  3. ^ Commonwealth of Massachusetts, Special Commission on the Health Care Payment System (16 July 2009). "Recommendations of the Special Commission on the Health Care Payment System. Appendix C: memos on basic payment models and complementary payment-related strategies" (PDF). Archived from the original (PDF) on 2011-06-04. Retrieved 2010-03-11.
  4. ^ Satin DJ, Miles J (2009). "Performance-based bundled payments: potential benefits and burdens" (PDF). Minn Med. 92 (10): 33–5. PMID 19916270. Archived from the original (PDF) on 2017-02-02. Retrieved 2016-09-09.
  5. ^ Miller HD (2009). "From volume to value: better ways to pay for health care". Health Aff (Millwood). 28 (5): 1418–28. doi:10.1377/hlthaff.28.5.1418. PMID 19738259. Archived from the original on 2013-04-15.
  6. ^ RAND Corporation. "Overview of bundled payment". Archived from the original on 2010-12-29. Retrieved 2010-03-11.
  7. ^ Obama B (15 June 2009). "Remarks by the President at the annual conference of the American Medical Association". whitehouse.gov. Retrieved 2010-03-11 – via National Archives.
  8. ^ Cite error: The named reference cg was invoked but never defined (see the help page).
  9. ^ Deirdre Baggot (July 2012). "Top 10 Considerations for Clinical Service Line Leaders". GE Healthcare Camden Group. Archived from the original on June 17, 2016. Retrieved June 13, 2016.