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.
This resource provides guidance and templates to help organizations work with commercial payors to develop successful and compliant bundled payment and shared savings arrangements.
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.
In this Health Affairs blog post, Senior Program Officer Michael Painter discusses different RWJF-funded projects testing the bundled payment model.
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.
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.
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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February 27, 2011 | Toolkit
Prometheus payment
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.
February 27, 2011 | Toolkit
Which ECRs to focus your pilot on.
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.
February 28, 2011 | Toolkit
Toolkit is designed to provide the information needed to gain a solid understanding of the PROMETHEUS Payment model, consider the potential benefits of a pilot implementation and take action.
February 27, 2011 | Toolkit
Funded by RWJF, the current pilot implementations are designed to test the validity of the PROMETHEUS model.
February 27, 2011 | Toolkit
You can conduct your own analysis through the ECR Analysis Tool on the HCI3 website.
February 27, 2011 | Toolkit
The CEO is the ultimate decision-maker and is accountable for the organization’s success or failure.
February 27, 2011 | Toolkit
A fundamental question in contracting for an ECR with an existing provider organization is whether to make ECR payments prospectively or retrospectively.