Bundled payments case studies: Horizon Healthcare Services & Arkansas Blue Cross and Blue Shield

Atlantic Information Services has released the report “Bundled Payment Models: Bottom-Line Strategies for Insurers,” which includes case studies of Horizon Healthcare Services and Arkansas Blue Cross and Blue Shield.

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Both payers developed successful bundled payment programs. The report offers information on:

•    How the payers established cost and quality benchmarks
•    How the payers shared cost and quality data with providers
•    Difference between retrospective and prospective bundled payments
•    Financial and quality outcomes observed by the payers thus far
•    How payers share savings with providers
•    How to handle unexpected issues, such as “outlier” episodes

Bundled payment programs continue to roll out, with mixed success. While Horizon Healthcare Services and Arkansas Blue Cross and Blue Shield may have found the key to making bundled payments work, California’s three-year bundled payment pilot program failed to deliver the expected cost savings.

Bundled payments remain in their infancy, but interest continues to grow.

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