Research Finds Momentum for Health Care Payment Reform in U.S.

Research Finds Momentum for Health Care Payment Reform in U.S.

Research Finds Momentum for Health Care Payment Reform in U.S. 

HCI3 Releases Report on Bundled Payment Health Care Reimbursement Progress

Media Contact:
Cary Conway

WASHINGTON — June 11, 2013 — Efforts to change the way health care providers are compensated in the U.S. from fee-for-service to payment for a bundled set of services are well underway according to a new study released at the National Bundled Payment Summit. The independent research also found that payment reform requires the adoption of new operating platforms that were not previously used by health plans and that providers can band together to accept financial risk and improve their collective performance. The research was commissioned by the non-profit Health Care Incentives Improvement Institute™, Inc. (HCI3™) and conducted by Bailit Health Purchasing, LLC.

“This report updates our research from last year and shows that innovation is continuing to progress in bundled payment pilots,” said Francois de Brantes, executive director for HCI3. “In addition, early adopters such as Horizon Healthcare Services and Blue Cross Blue Shield of North Carolina are now moving to fully scaled implementations and making bundled payments a core provider reimbursement strategy.”

Those using bundled payment in a similar study from last year and still doing so, have broadened the application. While some early commercial-sector adopters have abandoned the payment methodology, other payers and providers in both the public and commercial sectors are making bundled payments part of their permanent reimbursement strategy.

At the same time, certain challenges continue to plague bundled payment efforts, including a lack of data, lack of engaged leadership, lack of resources to implement alternative payment methodologies and lack of engagement in local efforts by national plans. However, these challenges are no different than those affecting alternative payment reform efforts across the country.

“Select private and public payers across the U.S. are making a significant commitment to employing bundled payment as a high priority purchasing strategy,” said Michael Bailit, president of Bailit Health Purchasing and study author. “They are committed to reforming payment in order to reduce waste and improve quality. We will continue to have much to learn from their experiences as their efforts progress.”

The study focused on the 19 active bundled payment implementation sites in the U.S., pulling out specific lessons in two case studies, one on two regional Blue Cross and Blue Shield plans and one on Remedy Partners, a "convener-awardee" in the Medicare Bundled Payment for Care Improvement pilot. Each offers significant insights on how to spread and scale bundled payments throughout the country.

The PROMETHEUS Payment model was launched in 2006 with the support of the Robert Wood Johnson Foundation through four initial pilots and is now being implemented in many states including Colorado, Michigan, New Jersey, New Mexico, New York, North Carolina, Pennsylvania, and South Carolina.

About Health Care Incentives Improvement Institute™, Inc.
The Health Care Incentives Improvement Institute, Inc. (HCI3®) is a not-for-profit multi-stakeholder umbrella organization for Bridges to Excellence® and PROMETHEUS Payment®. The mission of the organization is to create significant improvements in the quality and affordability of health care by developing and implementing programs that recognize and reward physicians, hospitals and other health care providers that deliver safe, timely, effective, efficient, equitable and patient-centered care. HCI3 offers a comprehensive package of solutions to employers, health plans and coalitions to improve the flawed incentives that currently permeate the U.S. health care system.

About Bailit Health Purchasing, LLC
Bailit Health Purchasing is a health care consulting firm dedicated to working with public agencies and private purchasers to expand coverage and improve health care system performance.

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