There are three ways the next generation of bundled payments should facilitate implementation of population health strategies, researchers contend in a Journal of the American Medical Association report.
The researchers noted the expansion of mandatory episode-based payments is already in the works. For instance, the effective date for implementation of cardiac care bundled payment initiatives is October.
Researchers said there are limitations with current bundled payment models, as they "retain the fee-for-service incentive to do more, especially for conditions without well-defined criteria for intervention, and to select healthier patients, potentially increasing low-value care use that offsets efficiency savings." They added: "Bundled payments must be restricted to conditions with a clear starting point and those in which there is only limited physician and patient discretion."
Moving forward, researchers said the next generation of bundled payments should integrate population health. This can be done by doing three things: extending the duration of the bundles, "expanding the accountable entities beyond hospitals," and "integrating bundled payments with global budget models within ACOs."
Researchers contend doing these three things "could better align episode-based payment with population health and offer a smoother path to global budgets."
"Testing bundles nested within overarching collective accountability through bundle-ACO integration is particularly promising. There will be ample opportunity to inform bundle design based on findings from voluntary and mandatory Centers for Medicare & Medicaid Services programs and private insurer initiatives. Innovations in bundled payment design could increase their attractiveness to commercial and public payers alike in the pursuit of higher-value care," they concluded.
More articles on healthcare finance:
41% of healthcare spending attributed to 12% of Americans, study finds
Texas Children's records $36.2M operating loss on insurance arm
Operator of 179 cancer treatment centers files for bankruptcy