Studiomaca sat down with Francois de Brantes, executive director of the Health Care Incentive Improvement Institute to address our customers’ top questions about bundled payments. Francois addresses the following questions:
How bundled payments work
- How is the member benefit and product design handled for bundled payments?
- How is the member obligation handled in bundled payments?
- How is risk adjustment managed in prospective bundled payments?
- Who takes responsibility of costs incurred by patients going outside of the care team?
Inside bundled payment models
- How do the Prometheus ECRs (Evidence-informed Case Rate) compare to the CMMI BPCII (CMMI’s Bundled Payments for Care Improvement Initiative) episode definitions?
- How configurable are the ECRs?
- Should we include HIE (Health Information Exchange) interoperability measures as part of our bundled payment metrics?
Best practices for getting started with bundled payments
- Is prospective bundled payment the ultimate goal, and should we first start with retrospective?
- For a provider interested in bundled payments, what are the first steps to pursue?
- For a payer interested in bundled payments, what are the first steps to pursue?
- How should we determine which episodes to start with?