“Because Medicare and commercial payers are likely to continue using both bundled payments and global budgets, ensuring that bundles and ACO programs are integrated will be important for the next generation of bundled payment models. Early evidence suggests that bundled payments and ACOs can be complementary (eg, Medicare’s ACO programs have primarily experienced savings from reductions in acute hospital and outpatient physician payments, whereas its bundled programs realized savings in postacute care payments).”
– Drs. Amol Navathe, Zirui Song, and Zeke Emanuel, 2017.1
This strategy is similar to what leaders from Dell Medical School, Drs. Bozic and McClellan, suggest with upstream bundled payments for conditions complementing population-based payment mechanisms.2
This could be similar to how we suggested in Module 4 that patient-centered medical homes and integrated practice units can collaborate and coordinate to provide whole-patient coordinated care and condition-specific expertise. To make this work on the payment side, it would be critical to align incentives and proactively share information on shared beneficiaries.1
ARTICLE
This article explores methods and implementation models for bundled-based payments and is am excellent primer for understanding practical applications.