The bundled payment model has taken hold for payers, and it doesn’t look like that momentum is about to slow down. According to a recent study, bundled payments are likely to grow by more than 5% between now and the next several years, making them the single quickest-growing payment model in healthcare. Bundled payments provide payers with an opportunity to streamline review processes and compensate providers more efficiently while reducing risk. Payments are standardized, using a predetermined price for a specific episode of care. The benefit is that you’ll have a much easier time controlling costs and the financial risk is moved from you to the healthcare provider.
On the other hand, healthcare providers are now incentivized to provide effective, efficient care, so that their costs come in less than a standardized episode of care reimbursement. This makes it a win-win situation, where the ultimate goal is controlled health care costs without a drop in quality or volume. Evidence of bundled payments’ effectiveness was shown by the Bundled Payments for Care Improvement Initiative that was able to cut the reimbursement cost of a specific joint replacement by over $3,200 without negatively impacting the number of procedures.
As bundled payments take greater hold on the healthcare industry, technology is beginning to have a major impact on how its implemented and managed. Here are three key ways that technology is impacting the bundled payments model.
1. Providing the Necessary Data.
As bundled payments become more popular, reporting and data functionality are moving to provide the information necessary to handle the new reimbursement model. Many data points were simply not necessary when paying on a per-service basis but are critical to determining the proper level of payment for a specific episode of care. As time goes on, you’ll be able to use these reports to constantly update and tweak your payment levels so that you aren’t overpaying or underpaying more often than necessary.
2. Enabling Efficient Collaboration with Providers.
One of the most exciting aspects about payment bundling is that no payer is in it alone. Bundled payments align the goals of payers, providers, and patients closer together than ever before, so many companies are working together to help each other. For example, UnitedHealth Group announced last month that it will contribute their data to the CMS Bundled Payments for Care Improvement models, which is a new payment model that aims to test bundled payments to ensure that quality of care and overall costs do not suffer. In the future, it isn’t unreasonable to assume that you will be able to continue to share information with other payers in order to make adjustments to existing models in real time, or simply tap into well-tested, proven bundled payment models.
3. Streamlining Payments.
Paper documentation has long been the bane of payers. With so much necessary documentation and multiple bills for each episode of care, it’s easy to quickly get overwhelmed with paper. Software solutions such as CAVO® make it much easier to store and find any necessary documentation, and surface the right data related to payments almost instantly. Because bundled payments are much simpler than paying on an ad hoc basis, you’ll find it much easier to integrate and communicate with providers than it was in the past.
Revamping the traditional healthcare payment model has not been easy, but bundled payments are continuing to grow as they prove that it is possible to maintain quality care without having a negative impact on costs. As healthcare technology providers continue to focus on supporting the bundled payment model for both payers and healthcare providers, this model will only become more scaleable and effective.