May 15 2018 By: Jennifer Cizek

The End of Islands: The future of bundled payments

Just six months ago, the industry was abuzz with questions and speculations surrounding the future of bundled payments. Today, the headlines are focused on innovators and forward-thinking organizations that have successfully adapted and captured value under these arrangements. Value-based care programs reward the quality of care provided and promote cooperation across care sites. In the case of bundled payments, a single payment is provided to cover the cost of an entire journey of care in which a patient may receive care from several different providers including a physician, hospital, or post-acute caregiver.

Bundled payments and other risk-based arrangements will make it impossible for organizations to continue operating as islands with siloed data. It is anticipated that by 2025, large payers will transfer about $2 trillion dollars in risk on to providers. The only way to survive the transition is to actively invest in developing the mindsets and capabilities required to succeed in a value-based world.

One of the biggest challenges organizations will face is data sharing to enable tracking patients across multiple care sites. Luckily, other industries like logistics and finance have gone through similar transitions that we can learn from. Take companies like Amazon and FedEx for example. FedEx revolutionized package logistics using predictive pricing and real-time tracking. Amazon transformed the retail shopping experience not only by giving customers access to countless items online but also by personalizing product recommendations to fit each individual’s interests and needs. These companies identified the power big data would have to disrupt the soon-to-be antiquated methods of operation and transformed their respective industries seemingly overnight.

This transformation in healthcare has already begun. Leaders recognize the value in collecting and analyzing data to personalize care. Perfecting these methods and scaling them quickly will be the differentiating capability that will separate the winners and losers in value-based care.

Indeed, the more innovative of the pack have already invested heavily in centralizing and analyzing patient data sets and are now using it to closely track and manage patient populations to optimize care. But it’s not too late for others! With low risk “training” programs like BPCI-Advanced available, organizations can start to develop these systems and internal building blocks to be successful as the industry continues down the path to value.

To learn more about organizations leading this transition, check out how John Muir Health has skyrocketed to 4th in the US and 1st in California under CJR.

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