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
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
  • 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
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 Payments
  • Bundled Payments – Benefits
  • Bundled Payments – Risks
  • Bundled 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

How Much Does A Colonoscopy Cost?
The Importance of Physician Leaders in Medicine Today: Blazing a Trail to Better Healthcare
EHR System Optimization Strategies For Top-Notch Performance
Telemonitoring at Work in the Netherlands
Scrutinizing Adherence Must Not Be Shortsighted

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

a woman walking on the hallway
6 Easy Healthcare Ways to Sit Less and Move More Every Day
Health
September 9, 2025
Clinical Expertise
Healthcare at a Crossroads: Why Leadership Matters More Than Ever
Global Healthcare
September 9, 2025
travel nurse in north carolina
Balancing Speed and Scope: Choosing the Nursing Degree That Fits Your Goals
Nursing
September 1, 2025
intimacy
How to Keep Intimacy Comfortable as You Age
Relationship and Lifestyle Senior Care
September 1, 2025

You Might also Like

A New Call-to-Action: Strong Is the New Skinny!

January 23, 2013

Medical Marijuana Sellers Offering Online Coupons To Attract Patients

May 22, 2011

Gardening Leads to Better Eating Habits, Quality of Life

May 2, 2011
Stolpner
DiagnosticsPublic HealthRadiology

Covering the Need for Healthcare: MRI Centers Improve Access to Diagnostic Imaging Throughout Russia

November 19, 2013
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?