Bundled Payment and ACO Arrangements – Clinically Integrated Payment Methodologies
I recently attended a series of seminars covering the legal and business aspects of bundled payment methodologies. This is an issue that my clinically integrated network clients are facing on a more frequent basis. I will cover a number of issues relating to bundled payment and the legal mechanisms needed to manage risk in upcoming blog articles. Check back for more information and grab our RSS Feed to be updated when new articles come out.
Bundled payment involves an agreement between a provider group and a payor for the management of a defined segment of care for an agreed price. A bundled payment would include one payment for all providers involved in the episode of care that is within the bundled area. All providers providing care within the episode of care are entitled to be covered under the bundled payment.
The idea behind bundled payment is to place providers across the spectrum of the applicable care continuum at financial risk and to provide shared financial incentives. In theory, this forces otherwise disjointed providers to cooperate to better coordinate care and to coordinate at a higher level with other elements of the continuum of care.
Bundled payment is one of the primary reasons why providers are mobbing toward clinically integrated health care systems. CINs provide a mechanism for providers across the continuum of care to agree upon protocols and other mechanisms to help them be more cost efficient in the management of bundled areas of care while maximizing the quality of care and outcomes provided to patients.
The Center for Medicare and Medicaid Services has developed a Bundled Payment Program
Read more here: Health Law Blog