Bundled Payments

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Overview

The growing body of evidence suggests that bundled payments are a promising alternative to the traditional fee-for-service payment model. Bundled payment programs vary widely in scope and include:

  • CMS’ Episode-based Payment Initiatives for MedicareBundled Payments for Care Improvement (BPCI) Advanced, Comprehensive Care for Joint Replacement

  • State-level models — For instance, those in Arkansas, Tennessee, Ohio and New York

  • Bundled models with commercial payers

  • Employer-based bundles — For instance, Walmart’s Centers of Excellence

Under these alternative payment methodologies, providers stand to benefit the most by redesigning care that enhances coordination among a patient’s care team, and optimizes the post-acute care.

Approach

At its core, we meet our clients where they are in their bundled payments evolution. Our solutions are designed to help users seamlessly navigate the complexity of reimbursement structures under various bundled payment models. By integrating claims data with our own CMS claims data set, organizations can easily access our drill-down and roll-up analytics which exposes performance variation across patient populations, individual physicians and post-acute care providers. In addition to maximizing performance within various bundled payment arrangements, our services enable organizations to evaluate their participation in specific bundled payment programs.

Interested in learning more? 

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