2 Advantages, 2 Limitations of Bundled Payment Participation
By - Are bundled payments the new future of healthcare? The expansion of bundled payments has been actively present within policy activity over the past three decades of healthcare reform, consistently being derailed due to factors such as physician autonomy concerns and an array of implementation hiccups. The significance of bundled payments is indeed tangible and quantifiable. Between 2020 and 2028, bundled payments are anticipated to be set at 96 percent of what would have otherwise been paid, according to the American Hospital Association.
As budding payment models associated with value-based reimbursement continuously gain traction across the healthcare industry, questions regarding the extent of both bundled payments’ advantages and disadvantages linger. Consider these two highlighted benefits and detriments bundled payments pose:
Increased savings, payment efficiency
Healthcare payers are reaping financial rewards because of bundled payment initiatives, confirmed HealthITAnalytics.com, especially in relation to areas of complex care costs, such as oncology. UnitedHealthcare confirmed a one-third reduction in breast and colon cancer costs following oncologists’ enrollment in a pre-established payment schedule for conventional treatments.
Similarly, bundled payments may be keeping costs advantageously low. Bundled payments slashed cancer costs – predicted to hit $207 billion by 2020 – by over one-third, as EHRIntelligence.com confirmed.
Greater flexibility, adaptability
As RevCycleIntelligence.com reported, the Centers for Medicare & Medicaid Services (CMS) confirmed bundled payment initiatives handling payment via a retrospective arrangement promote greater adaptability. When healthcare providers are able to choose which conditions to bundle, this helps determine how payments will be allotted among participating providers, says CMS.
Untrustworthy data negates benefits
If healthcare providers lack timely, trustworthy data, the benefits of risk-adjustment pricing mean little, as RevCycleIntelligence.com stated. Primary issues currently existing within the bundled payment realm involve a lack of accurate and up-to-date data. Just as a new car instantly drops in value once it is driven off the lot, antiquated payment data is perhaps simply irrelevant. Such data, far from static, must be considered as being actionable.
Additionally, problems are arising. For instance, needed data is often not available, payment models cannot always be seamlessly and effortlessly integrated, and variation exists among healthcare practices regarding the operational alignment of innovative payment strategies, as RevCycleIntelligence.com confirmed.
Rural hospitals face challenges managing post-acute realm
Successful management of bundled payments necessitates the execution of keen post-acute realm efforts. Rural hospitals – especially those already facing a hearty plethora of challenges – will perhaps find the management of a post-acute realm especially challenging, as RevCycleIntelligence.com additionally stated.
Rural hospitals may find it arduous to connect effectively with partner networks and communicate beyond the confines of their own four walls. Care coordination technology solutions, says RevCycleIntelligence.com, may offer a cleaner picture of what the anticipated back end looks like following investment efforts.
The question perhaps remains: to bundle or not to bundle? As new bundled payments advantages and concerns step into the forefront, it is indeed hopeful healthcare payers will be able to tackle upcoming challenges with preparation and ease.
