bundled payment

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bundled payment

A single comprehensive payment made to healthcare providers—hospitals and physicians—for a group of related services, based on the expected costs for a clinically defined episode of care.
References in periodicals archive ?
CMS is also finalizing the cancelation of the hip fracture and cardiac bundled payment and incentive payment models the Episode Payment Models and the Cardiac Rehabilitation Incentive Payment Model that were scheduled to begin on January 1, 2018.
The principal difference between CCJR and an "expanded" episode payment is that, as a demonstration, CCJR applies only to a randomly selected, agency-designated "intervention group" of providers.
The care period runs parallel with the 90-day period for the AMI and CABG episode payment bundled.
Advancing Care Coordination through Episode Payment Models Track 1 (EPMs).
hospital, specialists, and PCPs) would look like this: severity-adjusted DRG rates for hospitals and disincentives for readmissions, risk-adjusted per episode payment to specialty providers (sometimes referred to as "contact capitation"), and salary compensation for PCPs--with all providers sharing in value-based (TCOC, quality, and outcome) incentives.
The discrete episode--whether it's a defined period of care for a stroke patient or the implant of a cardiac pacemaker --is what differentiates the episode payment approach from the accountable care organization model, in which providers are at risk for all health care services for a defined population of patients.
The dollar amount was computed by multiplying the percent change in episode payments by the average episode payment for the matched comparison group, annualizing the volumes to 12 months and summing within each HAC.
Altman, "Payment Reform Options: Episode Payment is a Good Place to Start" (2009) 28 Health Affairs w262.
An HHA must update the comprehensive assessment by completing the appropriate OASIS schedule the last 5 days of every 60 days beginning with the start of care date unless there is a partial episode payment (PEP) or significant change in condition.
In the case of a partial episode payment (PEP), a reduced episode payment is made based on the number of service days in an episode.
Conversely, episode payment, a form of value-based reimbursement, incents providers to coordinate in delivering the most cost-effective, evidence-based medical services across episodes of care.