Healthcare bundled payments is a payment model that addresses reimbursement between payers and providers per episode of care rather than for a particular medical service, like the ever-popular fee-for-service model. The goal of using this particular payment method is to transition healthcare providers from a fee-for-service model to a value-based medical care model. This reduces some of the financial strain for both patients and providers and helps elevate the quality of care that patients receive.
Uncertainty in the healthcare industry, market changes, and complicated legislation make it difficult for companies and providers to offer stellar health insurance plans. Amidst this uncertainty, medical care providers need to put together offers that will attract these new consumers that are looking for affordable and reliable healthcare.
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The concept of bundled payments has been around for a while now, yet the instances where providers have fully embraced it are rare. The complexity of the process, the skepticism regarding the benefits providers provide, and the necessary background to develop an efficient system has kept this reimbursement method in an incipient stage.
Until recently, employers had to navigate through numerous insurance plans to find one that would cover their employees and work within the company budget. A critical issue with this method is that each procedure or visit was billed separately, resulting in a catastrophic bill. The fear is that employees would not deem the coverage valuable because they are still required to pay out of pocket, even after the employer paid the initial cost of the procedures.
In recent years bundled payments have been gaining traction as an efficient solution for reducing healthcare costs. The United States spends a considerable amount of its GDP on healthcare, and yet our healthcare is nowhere near the best in the world.