Managed Healthcare Executive November 12, 2019
Matthew Beatty, Kevin Mehta

If the U.S. healthcare system ever successfully completes the transition to fee for outcomes in lieu of our current system of fee for volume, bundled payments are likely to play a key role.

The theory behind bundled payments is solid: Pay providers a risk-adjusted fixed amount to treat a certain medical condition—regardless of the number of services they deliver—and allow them to share in any savings when costs are below that amount. As a result of this payment structure, providers will be incentivized to deliver high-quality care that keeps patients healthy at a low cost.

However, while bundled payments have certainly shown some potential in this regard—particularly for some non-urgent surgical procedures—the healthcare industry has yet to identify the correct...

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