By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    photo of hands with blue veins
    8 Proven Tips on Finding Difficult Veins
    November 12, 2021
    tips for getting over the pandemic blues
    4 Proven Ways to Get Over the Pandemic Blues
    February 22, 2022
    medical industry innovations
    How is CNC Machining Transforming the Medical Industry?
    June 2, 2022
    Latest News
    Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
    May 16, 2025
    Learn how to Renew your Medical Card in West Virginia
    May 16, 2025
    Choosing the Right Supplement Manufacturer for Your Brand
    May 1, 2025
    Engineering Temporary Hospitals for Extreme Weather
    April 24, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    Doctors on Google: Manhattan Research Survey 2012
    July 23, 2012
    HealthCare’s Need for Transparency Goes Far Beyond Pricing
    December 10, 2012
    Medicare Payments to Providers Are Carved, Sliced and Chopped by Sequestration
    March 25, 2013
    Latest News
    Building Smarter Care Teams: Aligning Roles, Structure, and Clinical Expertise
    May 18, 2025
    The Critical Role of Healthcare in Personal Injury Recovery: A Comprehensive Guide for Victims
    May 14, 2025
    The Backbone of Successful Trials: Clinical Data Management
    April 28, 2025
    Advancing Your Healthcare Career through Education and Specialization
    April 16, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Bundled Payments: Rewarding Quality and Value
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Business > Finance > Bundled Payments: Rewarding Quality and Value
BusinessFinanceHealth ReformHospital AdministrationPolicy & LawPublic Health

Bundled Payments: Rewarding Quality and Value

Linda Ringquist
Last updated: April 16, 2014 8:00 am
Linda Ringquist
Share
3 Min Read
Bundled Payments
SHARE
Bundled Payments

Summary: The healthcare industry is transforming from fee-for-service to value-based payment systems.

Contents
Overview of Bundled PaymentsBundled Payments – BenefitsBundled Payments – RisksBundled Payment Models
Bundled Payments

Summary: The healthcare industry is transforming from fee-for-service to value-based payment systems. One of the fairly new forms of reimbursement to hit the streets is bundled payments.

Overview of Bundled Payments

The Medicare reimbursement system is in the process of transforming healthcare as we know it from a traditional fee-for-service model to a system that rewards based on quality, care coordination, accountability, and healthcare cost savings.

The Affordable Care Act sets forth bundled payments as part of the quest to provide quality healthcare.  The days when compensation was linked to volume and quantity are going by the waste side. One of the newer payment systems is called Bundled Payments. The premise is to pay for an episode of care collectively as opposed to billing for each individual service separately.  An example is a surgical procedure. Rather than each provider submitting multiple claims, one claim is submitted for the entire procedure. Reimbursement is shared among the participating providers.

More Read

Stanford Disaster Relief Program – Video
3 Major Technologies Providers Need for Population Health Management
Online Marketing Strategies for Clinical Trial Recruitment
Even More Tips for Building a Branded YouTube Channel
Maine Versus Vermont

Bundled Payments – Benefits

While bundled payments are still being piloted, there are inherent benefits to a bundling system:

  • Reward providers for improving coordination of care
  • Reward providers for improving efficiency of care
  • Reward providers for improving quality of care as opposed to quantity of care
  • Reduce healthcare spending
  • Increase provider accountability
  • Strengthen physician/hospital relationships
  • Participate in Medicare gainsharing programs
  • Reduce readmissions
  • Improve patient outcomes

Bundled Payments – Risks

While the benefits are many, no payment system is perfect. Certain risks also come to the forefront:

  • Financial Risk – Services are rendered at a discount to Medicare beneficiaries with the hope that cost savings will achieved. If cost savings is not achieved, the participating providers will share in the loss.
  • Design Risk – Providers must design bundled payment plans based upon historical Medicare cost data. The idea is to create a system that will reward physicians for performance. If the bundles aren’t priced appropriately or do not produce cost savings, the providers could experience losses.
  • Operational Risk – There are certain protocols and systems that need to be put in place in order to participate in these potential gainsharing pilots. These include the standardization of processes across all aspects of care. The failure to adhere to these standards can result in a loss to the providers.

Bundled Payment Models

The Centers for Medicare & Medicaid Services (CMS) has been tasked with implementing a pilot program, in which organizations can voluntarily choose to participate. Currently, there are 4 main models aimed to test different stages of services ranging from inpatient to post-acute care and from retrospective to prospective reimbursement.

Bundled Payments

 

TAGGED:bundled paymentsMedicare
Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

Clinical Expertise
Building Smarter Care Teams: Aligning Roles, Structure, and Clinical Expertise
Health care
May 18, 2025
Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
Health
May 15, 2025
Learn how to Renew your Medical Card in West Virginia
Learn how to Renew your Medical Card in West Virginia
Health
May 15, 2025
Dr. Klaus Rentrop Shares Acute Myocardial Infarction heart treatment
Dr. Klaus Rentrop Shares Acute Myocardial Infarction
Cardiology
May 13, 2025

You Might also Like

7 Ways to Prepare Your Staff for Better Patient Interactions
Hospital Administration

7 Ways to Prepare Your Staff for Better Patient Interactions

November 3, 2017
healthcare providers
BusinessHealth careHospital AdministrationNewsPolicy & LawTechnology

The Importance of Professional Webhosts for Healthcare Providers

July 19, 2017
debunking-myths-myth3.png
BusinesseHealthPublic Health

Debunking Digital Patient Recruitment Myths for Clinical Trials: Myth 3

April 19, 2016

Lessons from the Anthem Breach

February 12, 2015
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?