Saving a bundle
I signed up for the
BPCI (Bundled
Payments for Care
Improvement) initia-
tive when it was intro-
duced a couple of
years ago. The experi-
ence gave me an
insight into the world
of bundled payments.
The concept of BPCI
is relatively simple.
Medicare sets up the
fixed-price payment
— also known as a
bundle — that
includes financial and performance accountability for episodes of
care. The payment, which is based on the historic spending for the
surgery, covers everything from the day of surgery through 90 days
post-op. Setting up your own bundled payment system lets you and
your surgeons oversee and negotiate everything, including the implant
cost.
Say a patient comes in for knee surgery and Medicare offers a bun-
dled payment of $20,000. Expenses would be paid out of that bundle
— including physical therapy, the implant, the cost of surgery and
more. The orthopedic group hires an outside company to "convene"
the bundle, which means it would keep track of all of the spending for
the bundle, including any complications that occurred following the
surgery.
9 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • D E C E M B E R 2 0 1 7
• BOTH SIDES Implementing total joints and bundled payments at a surgical center
means experiencing both sides of the process — financial and surgical.
