bundled payment

(redirected from episode-of-care 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 ?
In an effort to progress toward value-based payments from the traditional fee-for-service model, Vantages affiliated physician practice in California, VRA, recently partnered with Anthem Blue Cross of California in an agreement to create a single episode-of-care payment for patients with a breast cancer diagnosis requiring radiation therapy treatment.
Harold Miller, executive director of the Center for Healthcare Quality and Payment Reform, suggested an episode-of-care payment plan through which hospitals and physicians jointly charge one price for all services included in a hospitalization.
Anthem Blue Cross of California and Valley Radiotherapy Associates Medical Group (VRA) have developed a new agreement for a single episode-of-care payment for patients with a breast cancer diagnosis requiring radiation therapy treatment.
Unlike the ACO model, episode-of-care payments do not discourage expensive procedures; they encourage physicians and hospitals to work together to achieve good outcomes at low cost.
Other initiatives include episode-of-care payments for joint surgery and soon CABG surgery and establishment of accountable care organizations (ACO).
The organizations may combine other health care initiatives--such as medical homes and electronic medical records--with new ways of paying for health care, such as global and episode-of-care payments, which bill for an entire injury or disease rather than each exam, test or treatment.
Episode-of-Care Payments--As stated in the 2008 Medicare hospital outpatient final rule, the agency is seriously considering ways to consolidate outpatient payments into larger, more comprehensive, episode-of-care payments.
TriZetto's patent-pending payment-bundling application automates and streamlines the processing of episode-of-care payments by QualChoice.
Additionally many states, payers and other groups are participating in experiments including bundled payments, episode-of-care payments, gain sharing demonstration projects, the Prometheus payment project, and pay-for-performance initiatives.
We're looking at episode-of-care payments and gainsharing models.
The patent-pending application will automate the processing of episode-of-care payments to BlueCross.
the measurement and reward of efficiency in healthcare, administrative simplification, healthcare affordability, bundled episode-of-care payments, and accountable care organizations.