What you missed at the 7th Annual National Bundled Payment Summit

Last week, the Clarify Health team and I attended the 7th Annual National Bundled Payments Summit. The conference covered a range of topics including what changes to expect from episode payment models, the challenges and opportunities bundled payments present to our industry, as well as best practices for managing these programs.

The biggest key takeaway from the conference is that bundles are here to stay. The concept of bundled payments is not new, and they’re not going away. Despite the uncertain political landscape, the foundational ideas behind episode payment models remain constant and hospitals are even actively thinking about setting up commercial bundles. The fact that healthcare executives are considering entering into this new payment model of their own accord is a highly suggestive sign that bundles have a bright future in our industry.

Here are three additional key takeaways:

Reframe the conversation on bundles to focus on the patient. One of the biggest challenges healthcare professionals face in the world of bundled payment arrangements is looking past the name of the concept and focusing on the purpose of these programs. This is why we see a shift in the conversation moving toward the concept of “episodes of care.” Thinking through these programs in the context of an episode or journey of care makes it easier to focus on who these programs benefit – the patient. The truth is that the less that is ‘done’ to a patient across a journey of care, the lower the cost and the higher the satisfaction and quality. If executed effectively, episode payment models provide the structure to make patient journeys more efficient and precise.
The right technology is the key to success in episodes. In order to truly realize the benefits of episode payment models, healthcare providers need the right tools to manage episodes of care. Currently, much attention has been given to retrospective analytics which focus on past performance. However, there is a strong need for both retrospective and predictive analytics at a granular level. An advanced analytics engine will allow providers to do three things:
• Understand variations in care workflows at the individual patient, clinician and facility level – to enable clinicians and care delivery partners to improve their performance
• Prescribe precise and personalized care journeys by risk-stratifying every patient – to produce a transparent care map that everyone can plan against from pre-op through full recovery
• Monitor and coordinate care in (near) real-time – to identify and address issues before or as they occur.
Innovation is the only path forward: In this new world of value-based care, innovation and operational improvements are inextricably linked, especially in a healthcare setting where providers have only begun to unlock the benefits of episodic care models and workflow redesign. This work demands a different approach and mindset; bundles necessitate a quarterbacking system across multiple care sites - far beyond the confines of the hospital EMR.

While there is still much work to be done to truly maximize the full value of bundled payments and episodes, healthcare leaders are committed to the Triple Aim – to improving cost, quality, and satisfaction across the continuum of care – and both payers and providers know that they need to get ahead of these models to compete for volume. Innovators can use this shifting reimbursement and marketplace momentum to continue pushing forward with new approaches to drive change and the real results that patients and families deserve.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

© Copyright ASC COMMUNICATIONS 2020. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.


Top 40 Articles from the Past 6 Months