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Benefits of Bundled Payments in the Healthcare Industry


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Costs are continually rising in healthcare causing hospitals, providers, and facilities to face challenges with new cost-saving initiatives. Combining services to bundle payments in healthcare maximizes profits by setting costs somewhere between a fee for service schedule and full financial risk or capitation. Encouraging providers in all sectors of patient care to work together to achieve patient satisfaction ensures quality care while managing costs and achieving financial goals. Professional consultants can speak to your needs, review your current systems and find the strategies you can use with bundled payments to increase revenue.

What are Bundled Payments When it Comes to Healthcare?

The Centers for Medicare and Medicaid Services are working with providers and hospitals to reduce costs and increase profits. Reducing costs by changing from old separated services, each fending for their own profits, to bundled payment systems where providers and facilities work together to streamline the challenge of optimal patient satisfaction and quality healthcare leads to increased profits. Bundled payment systems start with primary care providers and specialists but can move on through the hospital experience and aftercare. Corporations are exploring the concepts of bundled healthcare options for their patients.

Participation in bundled payments can help the following entities with increased revenue and patient satisfaction:

  • Providers/Physicians
  • Hospitals
  • Rehab Centers
  • Post-Acute Care

Continuity of care is laid out through investigating analytics throughout the healthcare system to offer affordable care, incentives for providers, a streamlined flow of services, and optimal customer satisfaction. Bundled payments in healthcare can also apply to portions of the hospital which are often forgotten but need to be continually monitored to keep costs from skyrocketing.

One single payment for services averages out the high costs of healthcare but also ensures that the healthcare system receives a guaranteed level of payments. 

What are the Benefits of Bundled Payments in Healthcare?

Bundled payments in healthcare offer benefits to all parties concerned within the healthcare system. Increased profitability is the leading reason to consider bundled payments for your hospital or facility. Bundled payments involve analyzing all aspects of the current revenue cycle and identifying key cost opportunities. Areas that need to be investigated are:

  • Claims data
  • Possible opportunities for savings
  • Cost reduction opportunities within supply management
  • Patient care management
  • Telehealth usage for increased efficiency
  • Development of care coordination protocols
  • Review of care for high risk patients

Consultants who are experienced with bundled payments can review the present protocols within the institution and the workflows of the physicians, rehab, acute care systems, and the hospital to find money-saving processes. Exploring the entire patient experience and refining the process using bundled payments could increase revenue up to 8%. 

Looking into episodes of care to see what type of services can be bundled will allow all participants to share in the savings. There are two types of bundled payments in healthcare: retrospective payments systems and prospective model payments systems. The retrospective payment system still uses fees for service payments for providers, but averages out the cost according to the patient experience and the patient’s insurance. Tracking costs using a predetermined cost analysis allows for savings if the cost goes below the predetermined cost schedule. 

Within the prospective models, payors make a single lump payment to a certain facilitator and the payments are distributed out according to each party’s involvement with the patient care. This way, any savings can be added to the parties involved. In both situations, Medicare is finding that more and more physicians and hospitals are participating in bundled payment programs to increase their revenue and improve customer experience. 

Bundled Payments Strategies

Reviewing and investigating all systems within the healthcare system to find ways to bundle payments can save money and raise revenue. Three important factors to be aware of when considering saving money using bundled payments in healthcare are:

  • Inventory and monitoring of supply costs: outside of labor costs and supply costs are on top of the list to examine
  • Map any rebates received from specific codes to your bundled payments
  • Find essential information on patient satisfaction to improve policies and protocols by interviewing patients and their families in waiting rooms

These three factors can save money and help map out the best usage of bundled payments. Again, professional healthcare consultants can advise more in-depth ways to begin to utilize bundled payment options. Joint replacements are often a great starting place as they incorporate the entire process of surgery, post-op care, and rehab into one payment. Orthopedic and cardiovascular practices lead the charts with bundled payment programs in healthcare. Labor and delivery practices are also great candidates for bundled payment programs.

Bundled Payment Consultants in South Florida

If your hospital, facility, or physician group is in South Florida and you would like more information concerning bundled payments in healthcare, Bloom Consulting Agency can help. We can examine your current systems to see how bundled payments might increase your revenue and offer savings. One of our professional and experienced consultants will take your individual needs into consideration as they guide you through the process of moving your payment system to bundled payments. Call or visit our contact form today to see how we can help your practice increase revenue and overall success.