A new eBook from Regent Surgical Health outlines steps to help ambulatory surgery centers (ASCs) drive down the costs of healthcare while improving outcomes by deploying a bundled payment solution. Regent has been at the forefront of this innovative payment type, now the fastest growing in healthcare and expected to reach 17% of all medical payment types by 2023.
With a bundled payment, providers are paid a single payment for all the services performed to treat a patient undergoing a specific episode of care. For ASCs, bundled payments are increasingly being negotiated for regularly performed surgical procedures.
“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,” says Chris Stine, Regent’s Director of Bundled Payments & Corporate Compliance Officer. “These procedures offer some of the greatest opportunities for savings for the healthcare system.”
Regent CEO Chris Bishop adds: “As the shift continues towards value-based reimbursement, providers are realizing the value of the bundled payment for the population of patients in the middle of the pack in terms of projected needs and costs. For ASCs that effectively manage expenses, the concept has potential to drive patient volume through partnerships with both payers and self-insured businesses.”
Regent’s new eBook outlines what’s involved in the complex process of creating a bundle, suggesting that a successful bundle requires regulatory knowledge; pricing data from all potential providers; options regarding care pathways; an in-depth understanding of participating surgeons care pathways; opportunities for improvement; benefits programs; payer risk models; and much more. And accuracy is important as well: making just one mistake can wipe away the entire value of the contract and put a practice or facility at risk.
The eBook explains success with bundled payments requires a mindset of innovation and willingness to ignore old ways of practicing in order to conceptualize an entirely new process.
“Structuring the bundle to ensure every partner is aligned and executes is the biggest challenge,” Stine adds. “Value-based-care means sharing risk. Fully understanding all risk factors and how everyone interacts is crucial to developing a program that maximizes the opportunity for the surgeons and ASCs involved.”
Finally, in order to execute bundled payments well given their complexity, a rigorous process and a willingness to do extensive leg work up front are required. To get to speed quickly, critical information is essential: who is involved, who is controlling the bundle, how will patient progress be tracked, what are the expected savings and more. Providers must gather this information BEFORE contacting a payer. The bundle partnership needs to clearly articulate the total value proposition to get the chance to move forward and remain in the driver’s seat.
Regent’s eBook is available for download here.