Experimenting with bundled pay
Geisinger Health System’s bundled-payment model
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.