Bundled payments to account for 30%-45% of spine reimbursement in 3 years: 4 insights

Written by Anuja Vaidya | May 05, 2016 | Print  |

Providers who are early adopters of bundled payments can increase patient volumes from payers, according to a study published in Spine.

Researchers identified organizations that were engaged in bundled payment initiatives for spine care and surgery through a literature review and discussions with leaders in the field. Researchers interviewed 24 stakeholders across 18 organizations that collectively perform approximately 12,000 inpatient spine surgeries annually.


Here are four insights:


1. Fee-for-service reimbursement accounts for a majority of revenue, but several organizations expect 30 to 45 percent of their spine volume to be covered under bundled payments within three years.


2. Organizations cite new patient volume, increased surgical yield and financial benefits from efficiency improvements as reasons for adopting bundled payments.


3. However, institutions are more hesitant to adopt risk-based payment models for chronic back care, citing difficulty modeling risk and patient heterogeneity as well as difficulty aligning incentives.


4. The authors conclude that organizations should "begin considering reimbursement models that focus on noninterventional spine care." Also, "developments in spine reimbursement may apply to other procedure-based specialties, including orthopedics and cardiology."


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