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Bundled Payments

Bundled payment models assign a fixed, negotiated fee to cover a set of treatment services, encouraging providers to manage costs, while meeting high-quality care standards.

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Legal Issues in Designing Bundled Payments

Legal Issues in Designing Bundled Payments

This resource provides guidance and templates to help organizations work with commercial payors to develop successful and compliant bundled payment and shared savings arrangements.

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Bundled Payment: The Quest for Simplicity in Pricing and Tying Payment to Quality

Bundled Payment: The Quest for Simplicity in Pricing and Tying Payment to Quality

Though the strategy sounds simple, implementing a different way to pay for care across health systems and communities is a complex undertaking. This brief from Aligning Forces for Quality offers four steps that organizations considering a bundled payment pilot should follow.

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Bundled Payments: Toward A Challenging Yet Better Place

Bundled Payments: Toward A Challenging Yet Better Place

In this Health Affairs blog post, Senior Program Officer Michael Painter discusses different RWJF-funded projects testing the bundled payment model.

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Policy-Makers Will Need a Way to Update Bundled Payments That Reflects Highly Skewed Spending Growth of Various Care Episodes

Policy-Makers Will Need a Way to Update Bundled Payments That Reflects Highly Skewed Spending Growth of Various Care Episodes

This article from Health Affairs discusses how policy-makers must set base payment rates for episodes of care and update the rates over time to reflect changes in the costs of delivering care.

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Testing PROMETHEUS Payment

Testing PROMETHEUS Payment

Created by the Health Care Incentives Improvement Institute, the PROMETHEUS model packages payment around a comprehensive episode of medical care that covers all patient services related to a single illness or condition. This results report provides qualitative and quantitative analyses of the pilot.

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Payment Reform: Bundled Episodes vs. Global Payments

Payment Reform: Bundled Episodes vs. Global Payments

This issue brief from the Urban Institute presents a frank assessment of the merits and drawbacks of two payment models—bundled payments and global capitation—through a debate between Francois de Brantes and Robert Berenson.

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Related Topics

  • Payment Reform
  • Accountable Care Organizations
  • Patient-Centered Medical Homes
  • Pay-for-Performance

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Bundled Payment: The Quest for Simplicity in Pricing and Tying Payment to Quality

June 11, 2013 | Issue Brief

Local initiatives are showing how new methods for paying for health care can improve quality and control costs. This paper offers four steps that organizations considering a bundled payment pilot should follow.

Policy Makers Will Need a Way to Update Bundled Payments That Reflects Highly Skewed Spending Growth of Various Care Episodes

May 6, 2013 | Journal Article

Bundled payment is seen as a promising way to slow the growth of health care spending while maintaining or improving the quality of care.

Bundled Payment Across the U.S. Today

January 1, 2012 | Issue Brief

Issue brief examines ongoing bundled health care payment initiatives.

Conclusion

February 27, 2011 | Toolkit

Prometheus payment

The Fundamentals: How the Model Works

February 27, 2011 | Toolkit

Measures are based on commonly accepted clinical guidelines or expert opinions that define the best methods for treating a given condition from beginning to end.

Defining the Scope

February 27, 2011 | Toolkit

Which ECRs to focus your pilot on.

Launching the Pilot

February 27, 2011 | Toolkit

Health Plans will plug into the PROMETHEUS ECR Engine, a claims tracking/financial accounting system. It combines all data elements into one system, allowing payers and providers to price, reimburse and track ECR-related claims.

Analysis of Medicare and Commercial Insurer-Paid Total Knee Replacement Reveals Opportunities for Cost Reduction

January 1, 2010 | Issue Brief

Issue brief shows potential cost reduction with PROMETHEUS Payment® in total knee replacement.

Payment Reform

Topic

There is widespread agreement that the current method of paying for health care is broken. Learn how RWJF is testing new payment innovation models with the goal of managing costs and increasing quality.

Legal Issues in Designing Bundled Payments and Shared Savings Arrangements in the Commercial Payor Context

September 4, 2013 | Issue Brief

This resource provides guidance and templates to help organizations work with commercial payors to develop successful and compliant bundled payment and shared savings arrangements.

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