Bundled Payments and the Changing Healthcare Landscape

There’s been a lot of buzz in the industry around bundled payments since it has potential to transform the current healthcare system through payment reform.

So what is payment bundling? Also known as episode-based payment, payment bundling is the reimbursement of health care providers, such as hospitals and physicians, "on the basis of expected costs for clinically-defined episodes of care." It’s been described as a middle ground between fee-for-service reimbursement and capitation in which providers are paid a "lump sum" per patient regardless of how many services the patient receives.

Various models have shown that bundling payments could have a positive impact on containing costs and reducing practice variability.

It is expected that Medicare will implement these changes between 2016 and 2018, with the likelihood of the primary care audience being affected first. The 2016 election will also play a significant role in the future of legislation.

We anticipate that these bundled payment mechanisms will change the way that your finances are managed and collected. No doubt there will be a lot of confusion in the industry about how these bundled payments will play out. This is the ideal time to partner with an expert that will stay on top of all of the changes and will help to get you paid while you can focus on treating your patients.

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