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Bundled Payments: Current Strategies and Tools

by Matt Guldin | November 27, 2018

This report is available to subscribers of the Chilmark Advisory Service or may be purchased separately by clicking below. To accompany the release of this report, lead author Matt Guldin hosted a webinar on managing bundled services in healthcare.

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Recent CMS rule changes have once again brought bundled payments into the national spotlight. Addressing established uncertainty amongst payers and providers on the future of bundled payments, Chilmark’s latest report analyzes the market trends shaping this space and describes available IT solutions to help healthcare organizations (HCOs) adapt to these new value-based payment programs.

These models vary depending on payer, providers and type of service. Regardless, managing the efficient delivery and cost as well as understanding performance in a timely fashion will be key to success. This report examines the vendors that are either taking on risk in partnership with providers or are providing analytic solutions that enable the administration of bundled payments by payers and providers.

Adoption of bundled payments by type of facility and plan

The report starts by shedding light on the challenges that have plagued efforts to implement these payment models. This includes questions about how smaller-scale HCOs will adapt to increased collaboration requirements, to what extent actual cost savings can be realized through bundling, and concerns about the efficacy of existing IT solutions for enabling the payment models

In addition to providing context into how bundled payments might serve as a market disrupter, the report examines how existing health IT solutions can also limit this disruption. Since no vendor currently supplies a comprehensive solution for handling the intricate requirements of bundled payment programs, providers are forced to assemble a solution from various components of other tools. The report also looks to the future and identifies likely candidates for supplying a comprehensive solution once the market demands one.

Eighteen vendors were profiled for this report, divided into five categories: Acute EHR, Care Management, Consultants, Medical Devices, and Niche Episodic Payments. Each of these vendors is ranked according to their functionality in providing the following services: Opportunity Analysis, Episode Definition, Quality Reporting, Cost Reporting, Contract Management and Reconciliation, Patient Engagement, Care Navigation Workflow, and Clinical Pathway Support. By looking at these components, the report assesses the market’s progress toward developing a general-purpose bundled payments offering for provider organizations.

Vendors profiled: Archway HealthAver Inc., CareEvolutionCarrumCerner CorporationChange HealthcareClarify HealthDePuy Synthes AdvantageEpic Systems CorporationMedecisionMedtronic Orthopedic SolutionsnaviHealth IncOptumPremier IncRemedy PartnersStryker Performance SolutionsxG Health SolutionsZimmer Biomet Signature Solutions 

Pages: 46

Cost: $6,000

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