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Physicians Offer a Bundle of Opinions

Joe Cantlupe, for HealthLeaders Media, May 30, 2013

Bundled payments are one of the financial models emerging from the evolving healthcare marketplace. But a survey of physicians and hospitals shows a significant divergence of opinions about bundling. Practice size is just one factor.

As healthcare moves quickly toward value-based care, bundling is often depicted as the financial model with the most potential for starry-eyed success, in terms of quality and income. Yet a discordant gap in opinions has emerged, as large hospital and physician groups differ dramatically from smaller groups in their attitudes about bundling.

Bundling advocates see the financing formula as a way to get a handle on skyrocketing costs. Under the bundling initiatives, payments are made for multiple services under what is termed an "episode of care" for the patient. Instead of a surgical procedure generating multiple claims from many providers, the entire team is compensated with a bundled payment, on the premise that such a move would provide incentives for more efficient care.

A bundled savings program provides incentives for providers to share in any savings and can increase physician payments with improved patient outcomes. But while bigger players are wildly enthusiastic, those at the other end of the spectrum see it as more "bumbling" than appealing.

The larger groups are chomping at the bit to launch bundling programs, showing many are more excited about this approach than Accountable Care Organizations or patient-centered medical homes. But smaller entities, while seeing benefits of bundling, express trepidation because of what they deem to be the complexity of the payment plan.

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