A new paper, published in Clinical Gastroenterology and Hepatology, discusses alternative payment models that aim to realign financing to support GI services.
Here are six takeaways:
1. Fee-for-service payments typically encourage high-volume services rather than high-quality care.
2. New payment models, such as bundled payments and per-member, per-month payments, can help improve care and reduce waste.
3. The bundled payment model is one in which a provider is given a lump sum payment to cover the cost of services provided during the defined episode.
4. The bundled payment model can support improved care for a discrete procedure, such as a colonoscopy.
5. In the per-member, per-month payment model, a provider or group of providers receive a set amount per attributed life. However, the delivery model differs based on the complexity of the condition
6. The per-member, per-month payment model can support improved management of chronic conditions, such as IBD or hepatitis C.