CPR Releases Bundled Payment Resources

BERKELEY, Calif. – July 28, 2020 – The cost of health care in America has long been unsustainable and the economic downturn stemming from COVID-19 makes it even more critical for employers and other purchasers of health care to improve the quality and affordability of care for their employees and their families. One under-utilized approach is bundled payment. The non-profit Catalyst for Payment Reform (CPR) has developed a suite of resources to guide purchasers, including a report entitled “Bundled Payment Options in the 2020 Marketplace: A Guide for Employers and Other Health Care Purchasers” released today.

Bundled payment programs give health care providers a single target budget or price for an “episode” of care, defined by the Centers for Medicare and Medicaid Services as “a set of services provided to treat a clinical condition or procedure, such as a heart bypass surgery or a hip replacement.” The goals of bundled payment are to improve care coordination, quality and efficiency.

“Reforming health care in the United States means creating the right incentives when we pay physicians and hospitals,” said Suzanne Delbanco, PhD, executive director, CPR. “After pushing for payment reform for 10 years, approximately 60% of payments to health care providers are ‘value-oriented’ – aiming to improve the quality and affordability of care. But bundled payment has been slow to gain traction and we think it deserves more experimentation, as do many of CPR’s members. On their behalf we evaluated the health plans and other vendors offering bundled payment programs and found myriad ways purchasers can bring bundled payment to their populations.”

In addition to this latest report, CPR offers the following bundled payment resources for employers-purchasers:

• Evaluation questions and specifications to assist in holding health plans accountable for progress on bundled payment and assessing carve-out solutions.
• Evaluation Frameworks that offer purchasers a standardized tool to evaluate health plan and vendor-administered bundled payment programs.
• Summary scorecards for 10 bundled payment solutions from health plans and other vendors for CPR members.

“More than a Moment. Is Bundled Payment Poised for Primetime?” Virtual Summit

On Wednesday, July 29 from 1:00-3:30 pm Eastern, CPR hosted a virtual summit during which experts and industry leaders explored various bundled payment strategies and shared lessons from bundled payment programs for maternity care, primary care, bariatric surgery and joint replacement. Watch the recording. CPR is pleased to have the Peterson Center on Healthcare, BridgeHealth, Carrum Health, and Global One Ventures as sponsors for the event.

Funding for CPR’s work on bundled payment is provided by the Peterson Center on Healthcare.

About Catalyst for Payment Reform

Catalyst for Payment Reform is an independent, non-profit organization working on behalf of large employers and other health care purchasers to catalyze employers, public purchasers and others to implement strategies that produce higher-value health care and improve the functioning of the health care marketplace.  CPR’s diverse membership includes large private employers, state Medicaid, employee and retiree agencies and other types of health care purchasers and major benefit consulting firms.  For more information visit: catalyze.org and follow us on LinkedIn and Twitter.