Bundling is a much-talked about alternative payment model, but not many ambulatory surgery centers have taken the plunge yet. Here are five things to know about the Bedford (N.H.) Ambulatory Surgical Center and Harvard-Pilgrim bundled payments pilot program, according to an insurancenews report.
1. The bundled payments program between Bedford Ambulatory Surgical Center and health plan Harvard-Pilgrim Healthcare include routine colonoscopy. The bundled rate includes fees for the surgeon, anesthesiologist and all other clinicians. "I think more and more bundled programs will be coming down the way – it simplifies the system, reduces confusion, it's all up front" said Bedford ASC director of business strategy Chris Henderson, in the report.
2. The program, available to Harvard-Pilgrim Healthcare customers, includes more than one bundled fee. The fees are based on patient risk factors. Thus far, the fees for colonoscopy have not been made public to those outside of the Harvard-Pilgrim Healthcare plan.
3. Bedford ASC has offered bundled payments for colonoscopy and esophagogastroduodenoscopy to uninsured patients for several years, according to its website. The colonoscopy bundled payment pilot with Harvard-Pilgrim Healthcare launched just recently. Thus far this year, 44 patients have taken advantage of the program.
4. The program was launched with colonoscopy because it is a procedure with well-established benchmarks, predictable outcomes and few complications, according to the report. From the health plan perspective, the program has the potential cut costs. From the provider perspective, bundled payments help meet the growing consumer demand for price transparency and low-cost, high quality care. "We see it as a way to get everybody to have some skin in the game," said Harvard-Pilgrim New Hampshire medical director William Brewster, in the report.
5. In addition to GI procedures, Bedford ASC offers orthopedics, pediatric and podiatric services. The physician-owned facility opened in 1993. Since opening, the center has performed more than 124,000 procedures.
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