Chris Bishop is one of four business leaders discussing trends likely to drive ambulatory surgery center (ASC) 2019 prosperity in the latest issue of the ASC Focus newsletter published by the American Surgery Center Association (ASCA). Bishop’s contribution to the article, on the growing trend toward bundled payments as an opportunity to reduce healthcare costs, is a topic that’s time is now.

Bishop acknowledges that while movement toward shared savings, shared risk, and shared responsibility is paving the way for bundled payments, first movers in the ASC market have found the transition from concept to execution extremely complicated. Based on Regent’s experience facilitating the process, Bishop shares “how to” tips in three areas to help physicians and ASC leaders overcome barriers to execution. Following is a brief summary of each:

Closing the Knowledge Gap

The theory behind a bundled payment is quite simple. However, executing a successful bundle requires regulatory knowledge, contracts with all potential providers (e.g. home care, imaging, and PT), well defined care pathways by surgeon that allows for minor variances, pathway enhancement models, patient care coordinators, revenue cycle solution, clinical outcomes tracking, payer/employer strategy, and much more. To close the knowledge gap, practices and centers need to understand what data is necessary to structure a successful program and, maybe more importantly, where to find it. Another key decision is determining if all of these core competencies reside in your company or if its’ best to outsource most, if not all to ensure a successful bundled payment program.

Negotiating a Bundle

To remain in the drivers’ seat throughout bundle negotiations, it is essential to clearly organize the comprehensive value proposition prior to contacting a payer, answering critical questions including: who is involved and assuming risk for the bundle, how will patient progress be tracked, what are the expected savings, and more. Once negotiations begin, this homework pays off as we view our payers as partners in this effort to ensure all stakeholders are aligned. Although price is important, its’ really the other key terms of the bundle that are most critical from the payer’s perspective.

Identifying Key Stakeholders

Not every provider or facility will be willing to collaborate with other providers and accept responsibility for a patient’s episode of care. As a result, it is important to know how to identify the right partners for the value-based-care environment and to fully understand their motivations for being involved.

For more information on Regent’s approach to executing bundled payments, download our free white paper here.