Many experts believe piecemeal, volume-based fee-for-service payment encourages fragmented and inefficient care that not only costs more but is lower quality. One alternative is bundled payment—paying for services on the basis of an episode of care rather than individual tests, procedures or visits. IHA has spearheaded California pilots to test bundled payment approaches for orthopedic and maternity care and developed a wide array of resources, such as episode definitions and model contracts, to lay the groundwork for others’ work on bundled payments.
IHA’s engagement with bundled payment emerged from a value-based purchasing project as a promising opportunity to align incentives and improve coordination across care settings. In 2009, the California HealthCare Foundation funded an IHA pilot project to test implementation of bundled payments in California. A year later, the Agency for Healthcare Research and Quality awarded IHA a three-year grant to expand the bundled payment demonstration. In 2012-2013, IHA also served as a Facilitator Convener for the Center for Medicare and Medicaid Innovation’s Bundled Payments for Care Improvement (BPCI) initiative, supporting several California hospitals as they explored the BPCI opportunity.
IHA is committed to sharing knowledge, resources, and lessons learned from payment reform efforts through issue briefs and other publications for both policymakers and practitioners. Available resources, most of which were released in 2013 when the initiative concluded, are included below.