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Managing bundled payments.

Andrew Draper¹

¹HFMA, Texas Gulf Coast Chapter, USA. andy.draper@hcahealthcare.com

Healthcare Financial Management : Journal of the Healthcare Financial Management Association

|May 10, 2011

Summary

This summary is machine-generated.

Hospitals preparing for bundled payments should automate clinical IT tools. Success also depends on leadership, efficient processes, and strong financial management.

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Area of Science:

Healthcare Management
Health Informatics
Health Economics

Background:

Bundled payment models are increasing in healthcare.
Medicare's ACE demonstration project and Geisinger's ProvenCare initiative offer insights into these models.
Hospitals face challenges adapting to new payment structures.

Purpose of the Study:

To analyze the challenges and success factors for hospitals under bundled payment systems.
To identify key strategies for hospitals to thrive in a bundled payment environment.

Main Methods:

Analysis of results from Medicare's ACE demonstration project.
Review of Geisinger Health System's ProvenCare initiative.
Evaluation of early data on hospital performance in bundled payment programs.

Main Results:

Full automation using clinical IT tools is crucial for hospitals.
Leadership, organizational structure, and pricing strategies are vital.
Evidence-based guidelines, cost management, and case management are key success factors.

Conclusions:

Hospitals must adopt comprehensive strategies, including technological automation and strong operational management, to succeed with bundled payments.
Proactive case management and robust financial systems are essential for navigating bundled payment challenges.