Case studies of two insurers that have developed bundled payment systems to reimburse providers for several episodes, including total joint replacements, congestive heart failure and colonoscopy. From how the payers got started to the pitfalls they encountered and the latest financial and quality outcomes seen, this report walks through the entire process of building a bundled payment system.
Insurers across the country are experimenting with bundled payment initiatives that bring providers on board as partners in an effort to control costs while improving quality and member satisfaction. Bundled Payment Models: Bottom-Line Strategies for Insurers provides the details of how two insurers — Horizon Healthcare Services, Inc. and Arkansas Blue Cross and Blue Shield — developed successful programs to reimburse providers for episodes of care, combining payments for all aspects of treatment rather than paying providers individually for tests, office visits and procedures.
Filled with details on how they worked with provider groups to choose the episodes, agree on budgets, track quality measures and share savings — and what results they achieved — the report offers insights from senior executives at the two Blues plans on:
Bundled Payment Models: Bottom-Line Strategies for Insurers offers valuable tools for health insurers, providers and others involved in reforming how health care is delivered and financed. Order today! (Your order includes a PDF version available immediately when you order and a print version mailed to you within 5-7 business days.)
This report was adapted from a March 2014 AIS webinar presented by Lili Brillstein, Director of Episodes of Care at Horizon Healthcare Services, Inc., and Steve Spaulding, Senior Vice President of Enterprise Networks at Arkansas Blue Cross and Blue Shield. It has been updated by AIS’s editorial staff to include appendices ﬁlled with relevant background coverage of industry developments, state and federal agencies’ guidance and preparatory materials and other resources.
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