Choose the right bundled payment partner

How to build a successful bundled payment program

By Dina Overland 

FierceHealthPayer: What requirements should providers meet in order to participate in a bundled payment program?

Andréa Caballero: We have a short list of what would make a good provider partner. The first is that they have to have certain recognitions of excellence by nationally recognized organizations, including the Joint Commission and Consumer Reports. 

They also must have procedure volume of more than 300 total knee replacements and more than 300 total hip replacements per year. And they must have at least two surgeons with high volume of more than 200 procedures per year.

They also must demonstrate excellence through low complication rates and they must provide certain access, including 24/7 access to hospitals, ICUs and labs.

And then there are reporting requirements, so they should be willing to share requested data at the facility and physician level and they should participate in an orthopedic clinical registry.

Other factors like mortality rate, length of stay, post-surgical complication rate and readmission rate must also be addressed to determine providers are delivering quality care.