Study highlights key strategies, pitfalls for bundled-payment programs

New research highlights what makes bundled-payment programs effective and what gets in the way of their success.

A year ago, the Health Care Incentives Improvement Institute commissioned Bailit Health Purchasing to provide an overview of 19 active pilot programs testing bundled payments (PDF).

“Early adopters such as Blue Cross and Blue Shield of North Carolina and Horizon Healthcare Services are now moving to fully scaled implementations and making bundled payments a core provider reimbursement strategy,” Francois de Brantes, executive director of the Health Care Incentives Improvement Institute, said in a news release. The report was released Tuesday at the National Bundled Payment Summit in Washington.

The study revealed some concepts and strategies that could prove useful to the 450 organizations preparing to participate in the CMS' Bundled Payments for Care Improvement initiative that starts Oct. 1.

For instance, when plans were asked to name factors that have led to success so far, they listed a commitment to the initiative from top leaders; adequate resources for both program design and administration and provider contracting; and an open mind to new ideas.

Meanwhile, the study found that a lack of those things—as well as deficits of data and engagement in local efforts by national plans—caused the most problems for bundled payment efforts.

Some state Medicaid agencies are also showing some success with the model. “While they trail the commercial sector and Medicare in experimentation, bundled payments are taking a foothold in Medicaid agencies as a viable alternative to fee-for-service,” according to the report. “In the case of Arkansas, a Medicaid-commercial multipayer approach resulted in a faster spread of bundled payment than anywhere in the U.S.”

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