+353-1-416-8900REST OF WORLD
+44-20-3973-8888REST OF WORLD
1-917-300-0470EAST COAST U.S
1-800-526-8630U.S. (TOLL FREE)

PRINTER FRIENDLY

Bundled Payments: Current Strategies and Tools

  • ID: 4844858
  • Report
  • 48 Pages
  • Chilmark Research
1 of 5

FEATURED COMPANIES

  • Archway Health
  • CareEvolution
  • Cerner Corporation
  • Clarify Health
  • Epic Systems Corporation
  • naviHealth Inc
  • MORE

Recent CMS rule changes have once again brought bundled payments into the national spotlight. Addressing established uncertainty amongst payers and providers on the future of bundled payments, this latest report analyzes the market trends shaping this space and describes available IT solutions to help healthcare organizations (HCOs) adapt to these new value-based payment programs.

These models vary depending on payer, providers, and type of service. Regardless, managing the efficient delivery and cost as well as understanding performance in a timely fashion will be key to success. This report examines the vendors that are either taking on risk in partnership with providers or are providing analytic solutions that enable the administration of bundled payments by payers and providers.

The report starts by shedding light on the challenges that have plagued efforts to implement these payment models. This includes questions about how smaller-scale HCOs will adapt to increased collaboration requirements, to what extent actual cost savings can be realized through bundling, and concerns about the efficacy of existing IT solutions for enabling the payment models

In addition to providing context into how bundled payments might serve as a market disrupter, the report examines how existing health IT solutions can also limit this disruption. Since no vendor currently supplies a comprehensive solution for handling the intricate requirements of bundled payment programs, providers are forced to assemble a solution from various components of other tools. The report also looks to the future and identifies likely candidates for supplying a comprehensive solution once the market demands one.

Eighteen vendors were profiled for this report, divided into five categories: Acute EHR, Care Management, Consultants, Medical Devices, and Niche Episodic Payments. Each of these vendors is ranked according to their functionality in providing the following services: Opportunity Analysis, Episode Definition, Quality Reporting, Cost Reporting, Contract Management, and Reconciliation, Patient Engagement, Care Navigation Workflow, and Clinical Pathway Support. By looking at these components, the report assesses the market’s progress toward developing a general-purpose bundled payments offering for provider organizations.

Note: Product cover images may vary from those shown
2 of 5

FEATURED COMPANIES

  • Archway Health
  • CareEvolution
  • Cerner Corporation
  • Clarify Health
  • Epic Systems Corporation
  • naviHealth Inc
  • MORE

Chapter 1: Executive Summary

  • Introduction
  • Key Takeaways

Chapter 2: Current Bundled Payments Approaches And Strategies

  • Bundled Payments Definitions  
  • Why Payers Want Bundled Payments
  • How Payers decide what to pay
  • Bundled Payments and Population Health Management
  • Bundled Payment Market Adoption
  • Payer Efforts  
    • Centers for Medicare & Medicaid Services
    • Commercial Payers  
    • Self-insured Employers
  • Provider Approaches
    • Hospitals   
    • Community-based Providers
    • Post-acute Providers
  • Orchestration Challenges
    • Patient Identification
    • Patient Tracking Across the Continuum  
    • Care Process Redesign
    • Physician Engagement
    • Cost Variability
    • Data Sharing and Analytics
  • Technology Elements of a Bundled Payment Program
  • Bundled Payment Execution  
    • Assessing the Market  
    • Current and Anticipated Utilization Patterns  
    • Referral Patterns
    • Quality and Cost Profiles  
    • Optimizing a Network   
    • Network Suitability for Bundled Payments
    • Appropriate Patient Placement   
  • Designing a Network  
  • Future Direction for Bundled Payments  

Chapter 3: Vendors And Solutions  

  • Vendor Types
  • Inclusion Criteria
  • Maturity of Bundled Payments Market by Product Capabilities
  • Vendor Evaluations
  • Vendor Grades
  • Vendor Ratings  
    • Product Capabilities Ratings
    • Market Execution Ratings  

Chapter 4: Vendor Profiles
Archway Health
Aver, Inc
CareEvoluion
Carrum Health
Cerner Corporation  
Change Healthcare
Clarify Health
DePuy Synthes Advantage
Epic Systems Corporation
Medecision
Medtronic Orthopedic Solutions
naviHealth, Inc
Optum
Premier, Inc
Remedy Partners  
Stryker Performance Solutions  
xG Health Solutions
Zimmer Biomet Signature Solutions

  • Conclusions and Recommendations
  • Recommendations for Vendors
  • Recommendations for Providers

Appendix A: Scope And Methodology
Appendix B: About The Author

Tables And Figures

Chapter 1: Executive Summary
Chapter 2: Current Bundled Payments Approaches And Strategies
Table 1: Representative Medicare Post - Acute Costs  
Figure 1: Workflow and Timeline Variation Across an Episode: Joint Replacement Example
Figure 2: Bundled Payment Adoption by U.S. Hospitals
Figure 3: Bundled Payment Design and Operations Challenges
Chapter 3: Vendors and Solutions 
Table 2: Bundled Payment  Vendor  Comparison
Figure 4: Maturity of Available Bundled Payments Oferings by Product Capabiliies Category
Figure 5: Product Capabilities and Market Execution
Table 3: Product Capabilities Lete r  G r ade s by Vendor  
Table 4: Market Execution Letter  Grade s by Vendor  
Table 5: Product Capabilities  Harvey Ball  Key
Table 6: Product Capabilities Rating
Table 7: Market Execution Harvey Ball  Key
Table 8: Market Execuion Raing
Vendor Profiles
Table 9: List of  acronyms used

Note: Product cover images may vary from those shown
3 of 5

Loading
LOADING...

4 of 5
  • Archway Health
  • Aver Inc.
  • CareEvolution
  • Carrum
  • Cerner Corporation
  • Change Healthcare
  • Clarify Health
  • DePuy Synthes Advantage
  • Epic Systems Corporation
  • Medecision
  • Medtronic Orthopedic Solutions
  • naviHealth Inc
  • Optum
  • Premier Inc
  • Remedy Partners
  • Stryker Performance Solutions
  • xG Health Solutions
  • Zimmer Biomet Signature Solutions
Note: Product cover images may vary from those shown
5 of 5

Loading
LOADING...

Adroll
adroll