Hospitals with experience using bundled payment have an opportunity to take a leadership role in use of the fast-growing reimbursement model, according to a recent survey conducted by a unit of PwC.
The survey, conducted by PwC’s Strategy& team and called Strategy& Annual Bundles Survey, found that providers have been finding success with bundled payment: Two-thirds of providers surveyed improved quality and reduced costs using the bundled payment model.
But Anne Wong, director in the health strategy and advisory practice at PwC and a co-leader of the survey, says she believes there’s an opportunity to push bundles past the pilot stage and toward something much bigger.
“Nobody really has defined a standard or shown they are going to be leaders in this area,” she says. “I think there’s a great opportunity for a payer or provider to take that initiative and be a real pioneer in this space.”
Moreover, many providers are focusing on acute care bundles such as hip and joint replacements, as opposed to a chronic bundle model that might focus on diabetes care. Employers have expressed interest in chronic care models and there are many opportunities for payers and providers to work together to meet the wants of employers and consumers in the push toward a value-based model of care.
The survey, which polled 261 hospitals, 277 employers and 1,000 consumers nationwide, offered areas of key opportunities for health care stakeholders on the issue:
- Leverage local market characteristics and system strengths in bundles program design.
- Commit to an at-scale bundles strategy that covers 20-30 percent of health system activity.
- Proactively prepare for CMS-mandated bundles to be expanded beyond major joint replacement through identification of service lines with high variation. However, the AHA has urged CMS to halt expansion of mandatory bundled payment models to other geographic areas or conditions until there is enough time to assess the lessons learned under the existing models.
- Develop network of PCPs advocates in order to increase bundle awareness among consumers.
Payer and intermediary opportunities:
- Work with employers to create compelling offerings, as more employers are looking to payers (rather than providers) for bundle options.
- Serve as industry aggregators by sourcing and offering bundles across a variety of providers.
- Leverage/monetize data and analytics capabilities to support providers as they develop bundles.
- Develop metrics to market bundle quality to consumers who are unaware of bundles or are skeptical of the quality of bundled care.
- Make bundles a buyers’ market by approaching hospitals or health plans with clear bundle needs and expectations.
- Account for variations in consumer-defined excellence in healthcare across condition types; each bundle design should consider the attributes that matter most to its unique target customer.
There are many scenarios for aligning providers, payers and employers, but ultimately bundles solve a lot of problems consumers face when it comes to health care. “They’re [bundles] reducing costs, improving quality and there’s greater and greater awareness,” says Wong. But there’s now that opportunity to think bigger about what bundles can do for the delivery of care and how patients receive care.