Who Does Bundled Payments in Healthcare?

Healthcare bundled payments are a value-based payment model. This model keeps high quality in healthcare provision while increasing efficiency and reducing costs. Healthcare providers receive reimbursement based on the cost they expect to charge for a specific episode of a patient’s care.

Bundled payments are different from the fee-for-service model. This model pays providers for every service they provide to their patients. Bundled payments are also different from the capitation method. This method gives a provider a lump-sum payment for each patient regardless of how many services he or she received.

Bundled payments give patients an improved level of healthcare. This is because they create a structure that recognizes the physician as a clinical leader. Bundled payments also keep the risks to physicians manageable through payments for value rather than volume of healthcare.

The CMS (Centers for Medicare & Medicaid Services) has invested resources and time into offering bundled payments. In 2013, it introduced the Medicare BPCI initiative. This program has many medical facilities participating in it. These include hospitals, physician groups, and post-acute care centers. The program reimburses healthcare providers a single amount based on the amount of care the patient is estimated to require.

A number of commercial third-party payers are now showing interest in bundled payments. This is because they may reduce healthcare cost reimbursement. Some medical insurers are also now offering bundled payments. It is likely that more parties will soon be offering bundled healthcare payments.