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Jeffrey C. Bauer

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For different roads to bundled payments


Healthcare economist Jeffrey C.  Bauer, Ph.D., in a Hospitals & Health Networks  piece, pushes bundled payments but also urges flexibility in how they are implemented. Among his remarks:

“Indeed, the need to move away from volume-based payment is a rare area of general agreement between Republicans and Democrats in an era of relatively low economic growth. Regardless of how much Obamacare is weakened as a result of upcoming elections and Supreme Court decisions, it’s almost impossible for me to imagine any change in Congress that would increase appropriations for medical expenditures in the foreseeable future. Bundled payment is not the only way Congress can constrain spending on health care, but it is the one most likely to survive battles over budgets and regulations.”

“Leaders of hospitals and health networks should not be discouraged by the lack of a consistent definition of bundled payment. I actually find the variability encouraging because I strongly oppose one-size-fits-all approaches to solving the problems of our medical marketplace. …”

“Remarkable differences in their organization, leadership and operations prove there are several ways to provide world-class healthcare in the United States. I am consequently energized by the opportunity for innovative health systems to customize bundled payment to the unique characteristics of their own circumstances.”

”These bundled-payment mechanisms will all incorporate fixed payments for managing chronic diseases and caring for episodes of acute illness or injury, but they will be implemented in different ways. Successful efforts will take several years to evolve, and they will require multi-stakeholder partnerships between purchasers, payers and patients.”

“Leading the shift from fee-for-service to bundled payment would be a significant step in the better direction {for U.S. healthcare}. ”

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