Reforming Payment in an Evolving Environment: A Brief on Bundled Payment Successes and Challenges

Bundled payment models hold the promise of driving down health care costs while improving health care quality. As pilot projects have been conducted in the field, common barriers and themes have emerged, including administrative implementation hurdles, data and technology challenges, new emphasis on engaging patients in their care, and questions of whether true costs savings can realistically be achieved. This brief addresses the successes and challenges encountered in a recent bundled payment pilot project in Wisconsin, as well as the underlying transformative effects on patient 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 (TKR). The Wisconsin Collaborative for Healthcare Quality (WCHQ), a regional healthcare 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 TKR Pilot. PHPR is an initiative sponsored by Wisconsin’s all-payer claims data organization, the Wisconsin Health Information Organization (WHIO). PHPR supports the engagement of health care stakeholders in assessing, designing, testing, and implementing approaches to health care payment reform.

 

Read the full brief here.