Ex­per­i­ment­ing with bun­dled pay

Geisinger Health Sys­tem’s bun­dled-pay­ment model

Modern Healthcare - - Front Page -

Bundling has been in­cor­po­rated into a larger pack­aged pric­ing pro­gram known as ProvenCare, which is based on the premise that health­care de­liv­ery should in­cor­po­rate ev­i­dence-based prac­tices and en­cour­age the pa­tient and fam­ily mem­bers to be en­gaged part­ners in that care de­liv­ery. Bun­dled pay­ment for car­diac pro­ce­dures in­cludes: costs of the first physi­cian visit when surgery was deemed nec­es­sary; all hos­pi­tal costs for the surgery and re­lated care for 90 days af­ter surgery, in­clud­ing car­diac rehabilitation. Geisinger takes fi­nan­cial re­spon­si­bil­ity for any as­so­ci­ated com­pli­ca­tions and their treat­ment. Since 2006, com­pli­ca­tions from surgery have been re­duced by 21%, ster­nal in­fec­tions are down 25% and read­mis­sions have fallen by 44%, ac­cord­ing to Geisinger. And av­er­age length of hos­pi­tal stay has de­creased by half a day, ac­cord­ing to the sys­tem. The ProvenCare model since 2006 has been ex­panded to hip re­place­ment, cataract surgery, obe­sity surgery, pre­na­tal care, car­diac catheter­i­za­tion and cen­trally man­aged, ev­i­dence-based use of high-cost bi­o­log­i­cals.

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