Resource: Winning with bundled payments

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Until now, we have experimented primarily with two payment approaches. The fee?for?service approach that leaves the full insurance risk with the payor is now regarded as a root cause for poor coordination of care and system overutilization. Capitation, at the other extreme, provides a lump sum for the care of each individual – thus transferring the full insurance risk to the provider. In between is a system of “bundled payment,” an approach that is now the focus of great interest. However, defining the “episode of care” that is appropriate for a bundled payment, and creating case definitions that are consistent enough to be applied across varying payment arrangements, can be enormous challenges for providers.  Learn more about the approaches your peers are trying out in this useful whitepaper.

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