Designed to reduce the cost of high-volume, high-cost procedures within ASCs, bundled payments are expected to comprise 17 percent of all medical payment types by 2022, according to a new whitepaper by Westchester, Ill.-based Regent Surgical Health.
Here are three steps for implementing a bundled payment program:
1. Close the knowledge gap. To create a successful bundle, ASCs must have a wide depth of knowledge, covering regulatory issues, pricing data from all possible providers, care pathway options, participating surgeons' care pathways, opportunities for improvement, benefits programs and payer risk models.
"We've learned that each partnership has a unique approach to bundle structure and that what works well for Cigna, doesn't work for Aetna. Flexibility is key to finding the right program for the partners involved, as we are working with the payers to create these structures on the fly," said Regent Surgical Health CEO Chris Bishop.
2. Negotiate a bundle. Before approaching a payer, practices should answer critical questions such as who is involved, who is controlling the bundle, how patient progress will be tracked and what are the expected savings. Thoroughly research the payer before contacting them.
3. Identify key stakeholders. It's important to choose the right bundle partners because not every provider or facility can thrive under a bundled payment model. Understand the needs and concerns of each surgeon, facility, anesthesia partner, physical therapy vendor and implant vendor before implementing a bundle.
Download Regent Surgical Health's whitepaper here.
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