U.S. healthcare is on the cusp of bundled payments

BVWireIssue #160-2
January 13, 2016

A Harvard Business Review article points out that definite change is in the air that will have a significant impact on the revenue picture for healthcare providers. The change has to do with the move to bundled payments, in which a single payment is made for all providers who render services during a patient’s entire “episode of care” for certain medical conditions. The payment is then split up among the providers. This is designed to increase the quality of care and reduce healthcare costs.

Just started: The article points to the mandatory bundled payment program (Comprehensive Care for Joint Replacement Model) in 75 geographic regions that was scheduled to begin Jan. 1, 2016. The model, proposed by the Centers for Medicare & Medicaid Services (CMS), forces healthcare providers in certain areas into a bundled payments scheme for procedures such as hip and knee replacements. The proposal applies only to providers in large metropolitan statistical areas (MSAs).

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