Bundled Payment is one of the several reimbursement models introduced by the Affordable Care act (ACA) in order to bring down the mounting healthcare costs. The main idea of this payment model is to promote coordination among multi-specialty Providers and avoid redundant healthcare services. Although patients welcome such cost-saving payment models, Providers find it challenging to understand and implement them into their practices. As a result, their medical billing and collections get affected, making reimbursements even harder. Let us discuss more about the bundled payment method:What is Bundled Payment Model? In this model, healthcare services provided by multiple physicians to a patient during an episode of care get integrated to form bundled payments. By coordinating care, the bundled payment model increases the quality of patient care and reduces the inflating healthcare costs effectively. In addition, this payment model helps managing chronic illness in patients.Challenges faced by Providers: • The financial accountability of multiple Providers who have rendered services for an episode of patient care may be unclear sometimes. As a result, a Provider may end up getting lesser reimbursements when he deserved much more. • Bundled payments may call for a lot of administrative work and Providers may find it hard to timeshare between patient care, administrative operations and physician billing services.• Due to these problems, Healthcare Facilities are pushed to limit access to multi-specialty Providers during an in-patient stay.
• Certain patients may have more than one bundle that can be even more confusing to process during medical claims processing.Recent Medicare Initiatives: On July 2015, Medicare announced that it is mandatory to launch the bundled payment model in 75 US regions before the deadline of January 2016. Initiating bundles for each episode, while handling medical claims processing services, training staff, implementing new healthcare reforms, and updating technology is too impractical.Even though 1500 Providers agreed to participate in the Medicare bundled payment program, a research made by the Aval ere Health shows that the number is only 25% of the total Providers who expressed interests initially. The reason is undoubtedly the cost-cutting reimbursement models including the bundled payments. As the responsibilities increased, Providers are more inclined to focus on their medical billing and collections and patient care instead of venturing into some new payment models. They find it a mere financial risk!Solution: Bringing down the rising healthcare costs is mandatory. Therefore, Providers can participate in cost-saving payment models like bundled payments, while outsourcing medical billing and collections for extra help. This way, they can provide quality patient care as their medical claims processing services remain unaffected.
Source : articlesbase.com
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