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 ?
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.
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.
The report, Changing Physician Incentives for Affordable, Quality Cancer Care: Results of an Episode Payment Model, demonstrates the potential effectiveness of new approaches to the current fee-for-service payment model for cancer therapy.
Therefore, in the absence of quality oversight and performance incentives, an episode payment is more susceptible to skimping than a monthly design.
UnitedHealthcare launched its own episode payment pilot program in 2010 with five medical oncology groups around the country focused on determining best treatment practices and improving health outcomes.
About Remedy Partners Based in Darien, Connecticut and founded in 2011, Remedy Partners develops and manages patient-centric episode payment programs for employers, commercial health insurers, and government payers.
Per episode prospective payment should be more promising in terms of reducing the number of visits provided during an episode of care since agencies have the incentive to reduce the costs of the entire home health episode and carefully monitor the appropriateness of each visit in order to retain the difference between the cost of providing the episode of care and the episode payment rate as profit.