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Bundled payments can be gateway to payment reform


When insurers implement bundled payment projects, they're transforming care by focusing on quality and lowering costs, making it a strong gateway to propel payment reform, according to a report from the Robert Wood Johnson Institute.

In fact, the "most attractive element" of a bundled payment pilot is often the opportunity to prepare for "future demands of healthcare transformation," the report's authors wrote.

The report analyzed bundled payment pilots for total knee replacements organized by the Partnership for Healthcare Payment Reform (PHPR), a Wisconsin-based multi-stakeholder collaborative. As part of the initiative, Anthem Blue Cross Blue Shield of Wisconsin partnered with a surgery center and physician group.

In that pilot, the surgery center offered "joint camp," which was a one-day event required for all participating patients where they learned what steps they could take to ensure their best possible outcome after surgery. Nurses also were assigned to individual patients to help ease their care transitions throughout the surgery and recovery processes.

After implementing the PHPR bundled payment for knee replacements, Anthem achieved a 10 percent savings on each bundled knee replacement, due to a higher and more efficent quality of coordinated care.

All told, PHPR's experience with bundled payments demonstrates that even modest changes in reimbursements can "drive significant changes in data analysis and delivery redesign," the authors wrote.

And although the payment model is still relatively experiential--of the 11 percent of all value-based reimbursements, just 1.6 percent are bundled payments--it "has probably the most promise," Andréa Caballero, program director for Catalyst for Payment Reform, previously told FierceHealthPayer in an exclusive interview.

To learn more:
- read' the RWJF report

Related Articles:
Volume vs. value: The ongoing struggle
How to build a successful bundled payment program
Bundled payments: Lessons learned
Bundled payments need quality guidelines
How Cigna cultivates bundled payments