bundled payment

(redirected from episode-based payment)

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 changes in the proposed rule would allow the agency to engage providers in future voluntary efforts, including additional voluntary episode-based payment models.
American College of Surgeons-Brandeis APM, submitted by the American College of Surgeons, an episode-based payment model that uses claims data but expands on existing CMS value-based models by not requiring hospitalizations.
We see that the SDM technique can be deployed as part of three categories of APMs: In addition to an episode-based payment along the lines of SMARTCare or the Center of Excellence there are other alternative payment methodologies that could impact supply- and preference-sensitive care.
Medicare Payments for Common Inpatient Procedures: Implications for Episode-Based Payment Bundling.
Bundled Payment: This model, also known as episode-based payment, ties provider reimbursement to clinically defined episodes of care.
They go by many names--bundled payment, episode-based payment, case rate, global payment, packaged pricing and others--but they share a common feature.
ACA seeks to remedy this issue; the law has launched pilots to shift to an episode-based payment system.
And there are demonstration projects showing that episode-based payment and salaried physicians work just as well and cost less.
Few studies have addressed the effects of episode-based payment on cost and quality, although there are examples of episode-based programs having positive influences on structure and process quality measures as well as decreased costs of care.
Episode-based payment could most readily be adopted today for well-defined and time-limited episodes of care for procedures such as coronary artery bypass surgery or hip replacement.
These physician survey results are broadly consistent with other empirical data presented in the working paper that demonstrate that higher quality/more efficient care episodes cost on average 14 percent less - a result that helps quantify possible savings opportunities from episode-based payment 'bundling' initiatives.
Its clear that oncology physicians recognize the importance of this new performance-based, episode-based payment approach to cancer care.