Bundled Payment Models for Actinic Keratosis Management

Area of Science:

• Health economics
• Dermatology
• Healthcare payment reform

Background:

• Alternative payment models are increasingly encouraged by legislation.
• Bundled payments offer a potential solution for managing healthcare costs.
• Research on bundled payment design for dermatologic conditions is limited.

Purpose of the Study:

• To develop bundled payment models for actinic keratosis (AK) management.
• To evaluate the potential cost-effectiveness of these models.

Main Methods:

• A cohort cost identification study using insurance claims data (N=118,129).
• Calculation of direct costs and utilization measures for AK management.
• Development and analysis of eight distinct bundled payment models.

Main Results:

• Median-based bundled payment models demonstrated the largest theoretical cost savings.
• Certain models, like median-based with indirect payment, offered savings for a significant proportion of patients and clinicians.
• The 75th percentile payment models did not yield theoretical savings.

Conclusions:

• Bundled payments are a viable consideration for future healthcare payment reform in dermatology.
• Understanding disease management costs is crucial for advocating fair reimbursement.
• Dermatologists should engage with payment reform to support patient and clinician interests.