Dive into Bundled Payments or Wait?

Janavitz adds that 21st Century Oncologist's chief medical officer was instrumental in working with the medical advisory board and developing care pathway protocols for providers to follow, and addressing provider questions about the protocols and the case rates.

In anticipation of the bundled contract, the organizations also looked at their costs and provider utilization levels, benchmarking each organization regionally and nationally to look for possible savings.

Even with these efforts, Janavitz says the 21st Century Oncology is anticipating a reduction in patient volume and some services as a result of the bundled contract. How greatly these decreases will influence the book of business is perhaps their largest unknown in this process.

"There is a slight unit revenue reduction, but no payer will spend time on this unless there's some sort of unit revenue change out of the gate. We think it will be relatively minor, but we'll evaluate this after a year to see if [these national case rates for standard treatments] are living up to our financial expectations," he says.

In the meantime, 21st Century Oncology is looking for opportunities to enact bundled payment with other payers. How quickly more contracts follow will tell CFOs whether this is a good model to emulate.