Bundled payment programs provide many benefits for physician practices and ambulatory surgery centers (ASCs), including: cost savings, reduced unnecessary surgeries and readmissions, and better overall patient experience.
Bundled payments are a quickly growing payment type; by 2022, they are projected to reach a 17% share of all medical payment types. But organizing and operating a successful bundle payment program is complex and time-consuming. Each program is composed of multiple parts that are changing continuously, from risk factors to stakeholder needs.
Regent Surgical Health has developed a new guide to help physician practices and ASCs understand the components needed to build a successful bundled payment program. The guide walks through three strategies to get organizations up to speed with the market and ready to launch a bundled payment program:
- Close the knowledge gap
- Negotiate a bundle
- Identify key stakeholders
“It’s clear that bundled payment is continuing its growth and for good reason,” says Regent’s Director of Bundled Payments & Corporate Compliance Officer Chris Stine. “Providers and payers are beginning to recognize the opportunity bundled payments offer to greatly reduce the cost of certain high volume, high cost procedures like total joint replacements and spinal fusions.”
In a two-part blog series, Regent Surgical Health is exploring all three of these tactics (read the first installment here [link]).
Negotiating a Bundle
Before an organization begins negotiating with a payer, it must ask critical questions that will affect the value proposition, including:
- Who is involved?
- Who is controlling the bundle?
- How will patient progress be tracked?
- What are the expected savings?
Once negotiations begin, ASCs and practices should be prepared to be challenged on other terms that will have a dramatic impact on the program’s success, such as what is included or excluded in the bundle, who is accountable for risk, and when each of the payments are due.
Identifying Key Stakeholders
Bundling payments is an innovation that changes the way doctors practice medicine. This innovative method involves risk and requires working with other providers, but it also opens up exciting new opportunities for those who manage it effectively.
Choosing the right bundle partners means understanding the needs and concerns of
each partner, including surgeons, facilities (ASCs or hospitals), and anesthesia providers. It is crucial to identify the right partners to enhance a value-based care environment.
Interested in learning more about designing and executing a bundled payment program? Download the full whitepaper.