13 Most Challenging Aspects of Bundled Payments for Providers

Providers that have designed and implemented bundled payments say persuading physicians to deliver against the bundles, integrating data and running the performance-based model while operating on fee-for-service are some of the top challenges, according to a recent survey from Booz & Co.

Some pioneer providers have pursued bundled payments, particularly those for orthopedic and cardiac procedures, since 2006. Approximately 450 hospitals and health systems nationwide have signed on to implement bundled payments through CMS' model, and commercial payers are also active in the bundles arena.

For the survey, providers ranked the top three most challenging activities they were involved in from three categories: bundle design, implementation and scaling. Most providers either ranked the following items first, second or third. Findings are based on responses from more than 400 physicians and 150 hospital administrators.

• Scaling the number of procedures or conditions — 79 percent
• Scaling the number of facilities and/or geographies — 74 percent
• Designing risk- and gain-sharing arrangements — 68 percent
• Designing attractive physician alignment models — 61 percent
• Scaling the number of partners involved — 61 percent
• Care redesign efforts — 46 percent
• Integrating clinical and administrative data — 46 percent
• Scaling the number of care settings included — 45 percent
• Supporting bundles alongside fee for service — 39 percent
• Managing organizational bandwidth — 37 percent
• Finding suitable partners — 32 percent
• Persuading other providers to deliver against bundles — 29 percent
• Designing the bundles and determining which procedures and/or conditions to bundle — 29 percent

More Articles on Bundled Payments:

Survey: 5% of Employers Pursuing Bundled Payments
Where Commercial and Employer Bundled Payments Stand in Healthcare Right Now
4 Steps Hospitals Can Take to Pilot Bundled Payments

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