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Bundled Payments |
Build the foundation for a successful transition from fee-for-service to value-based reimbursement |
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In this new era of value-based reimbursement, it is imperative to work with a company that possesses not only deep domain expertise in building bundled payment systems, but also the consultative knowledge to implement successful risk-based reimbursement programs. MedAssets Bundled Payment Solution helps healthcare payors and providers prepare for the significant changes in payment structure resulting from healthcare reform. Combining expert-backed services with proven Web-based technology, MedAssets offers an end-to end approach to implementing bundled payment methodologies and managing reimbursement under a bundled payment system. Through a comprehensive readiness assessment, financial and clinical analysis, and consultative engagement, we provide healthcare organizations with complete visibility across a patient’s full episode of care. With this insight, organizations can develop actionable strategies designed to minimize risk under the new reimbursement paradigm.
MedAssets team of M.D.s and Ph.D.s has years of expertise in developing and implementing new episodes for providers and commercial health plans, the Centers for Medicare and Medicaid Innovation (CMMI) Bundled Payment for Care Improvement (BPCI) initiative, and the PROMETHEUS Payment® methodology. The team also has worked with several leading authorities in episode‐building methodologies, including the Integrated Health Association (IHA) and the Health Care Incentives Improvement Institute (HCI3). The MedAssets Bundled Payment Solution remains the only commercially-available product certified by HCI3 as "PROMETHEUS Payment-ready."
Utilizing MedAssets proprietary software, healthcare organizations are able to:
- Create new bundled episode definitions with ease
- Implement and monitor fee-for-service claims within episode budgets
- Report on financial and quality metrics
- Administer payment reconciliation
- Monitor and track the patient’s care pathway through the episode of care
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Key Features |
- Supplements current claim system and processes via an easy-to-install Web-based solution
- Associates all claims for a particular episode or condition into a single bundle
- Adjusts risk and severity around an individual patient based on multiple co-morbid factors
- Separates the typical costs of care from potentially avoidable complications
In addition, through analysis of patient data, healthcare payors and providers can:
- Define payor and provider reimbursement allocation
- Minimize risk through patient-level severity adjustments
- Improve per-patient margins with reduced potentially preventable complications
- Increase visibility across a full episode of patient care
- Manage multiple bundled payment methodologies
- Successfully develop and implement comprehensive delivery systems, such as integrated health networks and accountable care organizations
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