Why Bundled Payments?

Health care costs continue to spiral out of control and policy-makers have finally made it a top priority to shift the majority of care into value-based payment arrangements. There are many options for value-based payment models and we strongly believe that bundled payment arrangements are the best way to eliminate waste from episodic procedures. Creating accountability for providers, alignment across the care continuum and transparency for patients will undoubtedly result in an improved care delivery system.

The health care system’s current fee-for-service approach is extremely fragmented and would never survive in any other industry.  So why does it plague the largest sector of the United States economy?  There are a myriad of reasons.  With surgeons, hospitals, anesthesiologists, physical therapists, and primary care physicians often being managed by different organizations, break-down in communication with a patient is extremely likely. This fragmentation results in an increased likelihood of duplicative testing and ultimately more cost. As patients become more responsible for paying for their health care through high-deductible health plans, they end up having to pay for that waste. To make matters worse, patients currently receive bills from all the disparate parties mentioned above. It’s no surprise that patients have no idea what the “real” cost of a procedure is when they leave their physician’s office.  Moreover, are they aware of why a procedure is being performed at a hospital instead of an outpatient surgery center?

How does it Work?

In a Contessa Health bundled payment program, the physician is responsible for the quality and cost of care a patient receives. The best way to achieve high-quality outcomes in an efficient manner is to have someone involved throughout the entire episode, managing those disconnected care providers – a care coordinator. When the decision is made to have surgery, our care coordinators are there to help the patient through the entire episode. They will be there to answer any questions the patient may have as it relates to what they are experiencing, who will be involved and where care will take place.

Furthermore, the procedure has a predetermined rate – FOR THE ENTIRE EPISODE. The patient will not be burdened by receiving multiple bills.  They will receive one bill for the entire episode of care and will have the peace of mind of knowing exactly what it will cost before deciding to move forward with surgery.