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Payer Findings on Bundled Payments: 5 Things to Know

Bundled payments, though met with mixed reactions from healthcare stakeholders, are emerging as a tool to curb rising costs. How have payers approached this payment model?

Here are five things to know from the new Health Care Incentives Improvement Institute study: "Key Payer and Provider Operational Steps to Successful Implement Bundled Payments."

1. The study included input from six payers. One payer began working with bundled payments in 2006, while the others began within the past three years. Three of the six payers plan to add more bundled payments within the next two years.

2. Hip replacement and knee replacement were the two most commonly reported procedures for a bundled payment model.

3. Payers reported two different approaches to bundled payments. Bundled payments are either offered as the only model for providers offering selective episodes of care or contracted with only select, high-volume providers who are interested in the bundled model.

4. All payers included in the study reported having defined quality measures, which are used to assess provider performance for each episode of care. General quality measures included readmissions, avoidable complications, adverse events, Surgical Care Improvement Project Core Measure Set, care coordination, patient education and patient satisfaction.

5. Five of the six payers reported results from their analysis of bundled payments. All five observed a positive impact on cost, though one described the impact as "slight." All five also noticed quality improvement.

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