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Bundled Payment for Health Services

Blog
Vaccine Hesitancy, Sexual Misconduct in the U.S. Military, the Iran Nuclear Deal: RAND Weekly Recap
This weekly recap focuses on Black Americans’ vaccine hesitancy, sexual harassment and sexual assault in the U.S. military, rejoining the Iran nuclear deal, and more.
Mar 5, 2021
News Release
Bundled Payments for Surgical Procedures With Copay Waivers Creates Substantial Cost Savings
Providing patients discounts for using medical providers that agree to charge one set price for expensive procedures such as knee replacement surgery can result in savings for both patients and payers.
Mar 1, 2021
Journal Article
Payment for Services Rendered: Updating Medicare's Valuation of Procedures
Medicare appears to be overpaying surgeons for post-operative care associated many medical procedures. Federal officials should incorporate ways to more objectively measure the amount of postoperative care surgeons provide to patients
Jan 24, 2020
Journal Article
Association Between Hospitals' Engagement in Value-Based Reforms and Readmission Reduction in the Hospital Readmission Reduction Program
Hospitals participating in one or more voluntary Medicare value-based reform programs were less likely to readmit patients within 30 days of discharge than non-participating hospitals.
May 23, 2017
Report
Testing New Codes to Capture Post-Operative Care
This report summarizes RAND's pilot testing of a set of proposed nonpayment codes that physicians would use for post-operative visits. The goal of testing was to assess whether practitioners understood and could correctly apply the codes.
Jan 11, 2017
Journal Article
How Will Provider-Focused Payment Reform Impact Geographic Variation in Medicare Spending?
The Institute of Medicine has recently argued against a value index as a mechanism to address geographic variation in spending and instead promoted payment reform targeted at individual providers.
Jan 28, 2016
Journal Article
Medicare's Step Back from Global Payments: Unbundling Postoperative Care
Many experts believe that the U.S. health care system's continued dependence on fee-for-service payments is a key driver of excessive health care spending.
Jul 16, 2015
Journal Article
Hospital and Regional Variation in Medicare Payment for Inpatient Episodes of Care
Health care spending varies widely between geographic regions, but there is disagreement regarding the appropriate policy response.
Apr 22, 2015
Journal Article
Time to Reconsider Including Physicians in Bundled Payments?
Given new payment models and the changing relationship between physicians and hospitals, including physician costs in Medicare's Diagnosis-Related Groups (DRG) payments to hospitals could lead to better physician engagement in quality improvement efforts.
Apr 21, 2015
Report
Specialty Payment Model Opportunities and Assessment: Oncology Model Design Report
This report shares research and analyses of claims data related to the design of a payment model for specialty oncology services for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare & Medicaid Services.
Mar 17, 2015
Commentary
The Winding Path to Effective Bundled Payment
It's not unusual for a demonstration to fall short of its original objectives. Learning from such cases is part of the innovation process. This is especially worthwhile for bundled payment, which has many potential benefits for patients, providers, and payers.
Aug 29, 2014
News Release
Effort to Adopt Bundled Payments Across California Falls Short of Goals
A pilot program intended to implement and test a cost-saving strategy for orthopedic procedures at hospitals in California failed to meet its goals, succumbing to recruitment challenges, regulatory uncertainty, administrative burden and concerns about financial risk.
Aug 4, 2014
Journal Article
Bundled Payments Fall Short in California
Despite widespread interest in bundled payments as a strategy to control health care costs, implementation efforts continue to disappoint. A pilot program in California failed to meet its goals, succumbing to recruitment challenges, regulatory uncertainty, administrative burden, and concerns about financial risk.
Aug 4, 2014
Testimony
Improving Care for Medicare Beneficiaries with Physician Payment Reform
Physician payment policy is shifting from one that incentivizes the delivery of more services without regard to quality or outcomes to one that incentivizes the delivery of high quality, resource conscious health care. Thoughtful incentive design can ease the transition process for both physicians and the Medicare program.
Jun 5, 2013
Testimony
Efforts to Reform Physician Payment by Tying Payment to Performance
Public and private sector purchasers are actively working to design value-based payment programs to achieve the goals of improved quality and more efficient use of health care resources. How these programs are designed is a complex undertaking and one that will determine the likelihood of their success.
Feb 14, 2013
Q&A
ACOs: Making Organizations 'Accountable' for Care
The Affordable Care Act focuses primarily on extending coverage to uninsured Americans, but it is also intended to help curb cost growth. M. Susan Ridgely explains one of the key tools for doing that—the “accountable care organization,” an alternative delivery model intended to lower costs while also improving quality of care.
Dec 19, 2012
Journal Article
Medicare Postacute Care Payment Reforms Have Potential To Improve Efficiency Of Care, But May Need Changes To Cut Costs
ACA-mandated payment reforms need to achieve more than a one-time cost saving.
Sep 1, 2012
News Release
Bundling Payments to Curb Health Care Costs Proves Difficult to Realize
Under bundled payments, doctors, hospitals, and other providers share one fee for treating all aspects of a procedure such as a hip replacement or a chronic disease like diabetes. The approach should eliminate unnecessary care and improve quality, but putting it into practice is proving to be more difficult than anticipated.
Nov 7, 2011
Journal Article
Bundling Payments to Curb Health Care Costs Proves Difficult to Realize
Under bundled payments, doctors, hospitals, and other providers share one fee for treating all aspects of a procedure such as a hip replacement or a chronic disease like diabetes. The approach should eliminate unnecessary care and improve quality, but putting it into practice is proving to be more difficult than anticipated.
Nov 1, 2011
Report
Addressing Medicare Payment Differentials Across Ambulatory Settings
Medicare's payment for physician work and malpractice liability expenses is the same regardless of where a service is provided, but payments differ for facility-related components of care.
Sep 30, 2011

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