In 2013, The Center for Medicare and Medicaid Innovation launched the Bundled Payments for Care Improvement (BPCI) initiative, a program that proponents hoped could rein in health care costs by “bundling” payment for the full gamut of services that comprise an episode of care. The model certainly seemed like a good bet, as it would reward hospitals for reducing the cost of soup-to-nuts care for any of 48 conditions and penalize them for overruns. Indeed, bundled care for hip and knee replacement has been a dramatic success with clear savings and no increase in emergency department visits, readmissions, or 30-day mortality.
Using Bundled Payments to Improve the Patient Experience
In 2013, The Center for Medicare and Medicaid Innovation launched the Bundled Payments for Care Improvement (BPCI) initiative, a program that proponents hoped could rein in health care costs by “bundling” payment for the full gamut of services that comprise an episode of care. Bundled care for hip and knee replacement has been a dramatic with clear savings and good outcomes. However, research suggests that bundles may not work as well for other types of conditions such as heart attack. On reason is that hip and knee replacements are discrete, pre-planned events with a fairly standardized and consistent patient journey. Medical admissions follow a much more fragmented and much less coherent course. Bundled could be a powerful policy mechanism that encourages hospitals to create standardized clinical pathways and provide more coordinated, efficient care for medical conditions.