On the surface, bundled payment appears to be about health care financing. Beyond a change in the flow of dollars, however, bundled payment is truly about the transformation of care through a focus on improving quality and reducing costs. The Wisconsin experience has demonstrated that relatively modest changes in reimbursement methodology can drive significant changes in data analysis and delivery redesign. By aligning incentives through a single payment, patients receive care that is better coordinated across multiple providers, and costs are reduced. When coupled with quality data tracking and reporting, bundled payment has significant potential to drive down costs and improve value in health care.

 

Since 2010, the Partnership for Healthcare Payment Reform (PHPR), a Wisconsin-based multi-stakeholder collaborative, has worked to pilot a bundled payment project for total knee replacement. The Wisconsin Collaborative for Healthcare Quality, a regional health care improvement collaborative and leader of the Aligning Forces for Quality initiative in the state, has actively participated in PHPR’s efforts from the beginning and tracks quality outcomes for the total knee replacement pilot.

 

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Patient experience surveys, particularly those that use validated questions such as the Consumer Assessment of Healthcare Providers and Systems Clinician & Group Surveys (CG-CAHPS®), give providers feedback on patients’ office visits. Because these surveys assess patient reports about their actual experiences, not just their “satisfaction,” they produce more objective and actionable information. Practices can then take specific steps to improve the care experience.

 

In Greater Boston, the Massachusetts Health Quality Partners have worked with Consumer Reports to publish patient experience survey data on Massachusetts health care providers.

 

In Minnesota, Minnesota Community Measurement found technology helped improve practices and increase patient experience results.

 

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