Bundled Payments: How This Healthcare Payment Model Works | Ann Conrath, LMSW, MSW | RxEconsult

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Bundled Payments: What's In YOUR Bundle? Category: Healthcare Models by - December 28, 2015 | Views: 40394 | Likes: 0 | Comment: 0  

5 Questions You Need to Ask Yourself:

  • What is bundled?
  • Who is in the bundle?
  • What is the time frame of the bundle?
  • How is the bundle managed?
  • How is the bundle paid?
  • What is bundled?

The services covered by a single bundled payment are sometimes referred to as an “episode of care” and include all treatment related to a particular condition or procedure. There are already a variety of examples of episodes of care utilizing a bundled payment system, including total joint replacement for knee, hips and shoulder, spine fusion, sepsis, and pregnancy to name a few. 

Who is in the bundle?

The organizations involved in the bundle are typically the payers of the bundle and any providers and/or facilities that provide care during an episode of care. The payer can be a private insurance company, employer, or government insurance such as Medicare or Medicaid. The providers and facilities include hospitals, physicians, surgeons, anesthesiologists, hospitalists, primary care services, imaging such as MRI, therapy services, skilled nursing facilities, rehab facilities, home health services, and more.

Next: Time Frame And Bundle Management


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