Skip to main content

2021 | OriginalPaper | Buchkapitel

55. Designing Financial Incentives for Integrated Care: A Case Study of Bundled Care

verfasst von : Mudathira Kadu, Jason M. Sutherland, Lusine Abrahamyan, Walter P. Wodchis

Erschienen in: Handbook Integrated Care

Verlag: Springer International Publishing

Aktivieren Sie unsere intelligente Suche, um passende Fachinhalte oder Patente zu finden.

search-config
loading …

Abstract

Significant heterogeneity exists in the implementation of bundled care. This chapter outlines the different typologies of bundled care programs, and as a case study, highlights the implementation of bundled care in Ontario. There are several lessons for those considering adopting bundled care in their local context. In particular, great consideration should be given to the duration of treatment, the type of condition, the event triggering the beginning of the bundle and the care context and providers included in the bundle. More particularly, physician payment should be included in a bundle, as physicians make most of the decisions about care provided to patients. Finally, for health systems considering the implementation of bundled care programs, there must be widespread commitment and adoption from both payers and providers.

Sie haben noch keine Lizenz? Dann Informieren Sie sich jetzt über unsere Produkte:

Springer Professional "Wirtschaft+Technik"

Online-Abonnement

Mit Springer Professional "Wirtschaft+Technik" erhalten Sie Zugriff auf:

  • über 102.000 Bücher
  • über 537 Zeitschriften

aus folgenden Fachgebieten:

  • Automobil + Motoren
  • Bauwesen + Immobilien
  • Business IT + Informatik
  • Elektrotechnik + Elektronik
  • Energie + Nachhaltigkeit
  • Finance + Banking
  • Management + Führung
  • Marketing + Vertrieb
  • Maschinenbau + Werkstoffe
  • Versicherung + Risiko

Jetzt Wissensvorsprung sichern!

Springer Professional "Wirtschaft"

Online-Abonnement

Mit Springer Professional "Wirtschaft" erhalten Sie Zugriff auf:

  • über 67.000 Bücher
  • über 340 Zeitschriften

aus folgenden Fachgebieten:

  • Bauwesen + Immobilien
  • Business IT + Informatik
  • Finance + Banking
  • Management + Führung
  • Marketing + Vertrieb
  • Versicherung + Risiko




Jetzt Wissensvorsprung sichern!

Springer Professional "Technik"

Online-Abonnement

Mit Springer Professional "Technik" erhalten Sie Zugriff auf:

  • über 67.000 Bücher
  • über 390 Zeitschriften

aus folgenden Fachgebieten:

  • Automobil + Motoren
  • Bauwesen + Immobilien
  • Business IT + Informatik
  • Elektrotechnik + Elektronik
  • Energie + Nachhaltigkeit
  • Maschinenbau + Werkstoffe




 

Jetzt Wissensvorsprung sichern!

Literatur
Zurück zum Zitat Auditor General of Ontario. (2015). 2015 Annual report of the Office of the Auditor General of Ontario. Chapter 3.01 (pp. 70–115). CCACs-Community Care Access Centres-Home Care. Auditor General of Ontario. (2015). 2015 Annual report of the Office of the Auditor General of Ontario. Chapter 3.01 (pp. 70–115). CCACs-Community Care Access Centres-Home Care.
Zurück zum Zitat Bech, M., & Pedersen, K. M. (2005). Transaction costs theory applied to the choice of reimbursement scheme in an integrated health care system. Health Economics Paper, 2, 3–27. Bech, M., & Pedersen, K. M. (2005). Transaction costs theory applied to the choice of reimbursement scheme in an integrated health care system. Health Economics Paper, 2, 3–27.
Zurück zum Zitat Braun, D., & Guston, D. H. (2003). Principal–agent theory and research policy: An introduction. Science and Public Policy, 30, 302–308.CrossRef Braun, D., & Guston, D. H. (2003). Principal–agent theory and research policy: An introduction. Science and Public Policy, 30, 302–308.CrossRef
Zurück zum Zitat Busse, R., Geissler, A., Quentin, W., & Wiley, M. (2011). Diagnosis-Related Groups in Europe moving towards transparency, efficiency and quality in hospitals (1st ed.). Maidenhead: Open University Press. Busse, R., Geissler, A., Quentin, W., & Wiley, M. (2011). Diagnosis-Related Groups in Europe moving towards transparency, efficiency and quality in hospitals (1st ed.). Maidenhead: Open University Press.
Zurück zum Zitat Chen, L. M., Ryan, A. M., Shih, T., Thumma, J. R., & Dimick, J.B., (2015). Medicare ’ s acute care episode demonstration : Effects of bundled payments on costs and quality of surgical care. Health Services Research, 632–648. https://doi.org/10.1111/1475-6773.12681. Chen, L. M., Ryan, A. M., Shih, T., Thumma, J. R., & Dimick, J.B., (2015). Medicare ’ s acute care episode demonstration : Effects of bundled payments on costs and quality of surgical care. Health Services Research, 632–648. https://​doi.​org/​10.​1111/​1475-6773.​12681.
Zurück zum Zitat Crawford, M., & Houston, R. (2015). State payment and financing models to promote health and social service integration. Center for Health Care Strategies, Inc, pp. 1-16. Crawford, M., & Houston, R. (2015). State payment and financing models to promote health and social service integration. Center for Health Care Strategies, Inc, pp. 1-16.
Zurück zum Zitat Dixon, P., Hollingworth, W., Benger, J., Calvert, J., Chalder, M., King, A., et al. (2020). Observational cost-effectiveness analysis using routine Data: admission and discharge care bundles for patients with chronic obstructive pulmonary disease. Pharmaco Economics—Open. https://doi.org/10.1007/s41669-020-00207-w.CrossRef Dixon, P., Hollingworth, W., Benger, J., Calvert, J., Chalder, M., King, A., et al. (2020). Observational cost-effectiveness analysis using routine Data: admission and discharge care bundles for patients with chronic obstructive pulmonary disease. Pharmaco Economics—Open. https://​doi.​org/​10.​1007/​s41669-020-00207-w.CrossRef
Zurück zum Zitat Dummit, L., Marrufo, G., Marshall, J., & Tristan Ackerman, S. B. (2018). CMS bundled payments for care improvement initiative models 24 : Year 4 evaluation. Dummit, L., Marrufo, G., Marshall, J., & Tristan Ackerman, S. B. (2018). CMS bundled payments for care improvement initiative models 2­4 : Year 4 evaluation.
Zurück zum Zitat Evans, W. K., Nefsky, M., Pater, J., Browman, G., & Cowan, D. H. (2002). Cancer care Ontario’s new drug funding program: Controlled introduction of expensive anticancer drugs. Chronic Disease Cancer, 23, 152–156. Evans, W. K., Nefsky, M., Pater, J., Browman, G., & Cowan, D. H. (2002). Cancer care Ontario’s new drug funding program: Controlled introduction of expensive anticancer drugs. Chronic Disease Cancer, 23, 152–156.
Zurück zum Zitat Gross, D. L., Temkin-Greener, H., Kunitz, S., & Mukamel, D. B. (2004). The growing pains of integrated health care for the elderly: Lessons from the expansion of PACE (program of all—inclusive care for the elderly)(author abstract). Milbank Quarterly, 82, 257–282.CrossRef Gross, D. L., Temkin-Greener, H., Kunitz, S., & Mukamel, D. B. (2004). The growing pains of integrated health care for the elderly: Lessons from the expansion of PACE (program of all—inclusive care for the elderly)(author abstract). Milbank Quarterly, 82, 257–282.CrossRef
Zurück zum Zitat Hernandez, C., Jansa, M., Vidal, M., Nuñez, M., Bertran, M. J., Garcia-Aymerich, J., & Roca, J. (2009). The burden of chronic disorders on hospital admissions prompts the need for new modalities of care: A cross-sectional analysis in a tertiary hospital. QJM An International Journal of Medicine, 102, 193–202. https://doi.org/10.1093/qjmed/hcn172.CrossRef Hernandez, C., Jansa, M., Vidal, M., Nuñez, M., Bertran, M. J., Garcia-Aymerich, J., & Roca, J. (2009). The burden of chronic disorders on hospital admissions prompts the need for new modalities of care: A cross-sectional analysis in a tertiary hospital. QJM An International Journal of Medicine, 102, 193–202. https://​doi.​org/​10.​1093/​qjmed/​hcn172.CrossRef
Zurück zum Zitat Hussey, P. S., Mulcahy, A., Schnyer, C., & Schneider, E. (2012). 1. Bundled payment : Effects on health care spending and quality closing the quality gap. Rockville. Hussey, P. S., Mulcahy, A., Schnyer, C., & Schneider, E. (2012). 1. Bundled payment : Effects on health care spending and quality closing the quality gap. Rockville.
Zurück zum Zitat Jacobs, J., Daniel, I., Gr, B., Brown, A., & Wodchis, W. (2015). Bundling care and payment: Evidence from early-adopters. Jacobs, J., Daniel, I., Gr, B., Brown, A., & Wodchis, W. (2015). Bundling care and payment: Evidence from early-adopters.
Zurück zum Zitat Lewin Group. (2015). CMS bundled payments for care improvement (BPCI) Initiative models 2–4: Year 1 evaluation & monitoring annual report. Lewin Group. (2015). CMS bundled payments for care improvement (BPCI) Initiative models 2–4: Year 1 evaluation & monitoring annual report.
Zurück zum Zitat Marshall, L., Charlesworth, A., & Hurst, J. (2014). The NHS payment system : evolving policy and emerging evidence. Marshall, L., Charlesworth, A., & Hurst, J. (2014). The NHS payment system : evolving policy and emerging evidence.
Zurück zum Zitat Mukamel, D. B., Temkin-Greener, H., Delavan, R., & DR, P., Gross, D., Kunitz, S., TF, W., . (2006). Team performance and risk-adjusted health outcomes in the Program of All-Inclusive Care for the Elderly (PACE). Gerontologist, 46, 227–237.CrossRef Mukamel, D. B., Temkin-Greener, H., Delavan, R., & DR, P., Gross, D., Kunitz, S., TF, W., . (2006). Team performance and risk-adjusted health outcomes in the Program of All-Inclusive Care for the Elderly (PACE). Gerontologist, 46, 227–237.CrossRef
Zurück zum Zitat O’Connor, M., Hanlon, A., Naylor, M. D., & Bowles, K. H. (2015). The impact of home health length of stay and number of skilled nursing visits on hospitalization among medicare-reimbursed skilled home health beneficiaries. Research in Nursing & Health, 38, 257–267. https://doi.org/10.1002/nur.21665.CrossRef O’Connor, M., Hanlon, A., Naylor, M. D., & Bowles, K. H. (2015). The impact of home health length of stay and number of skilled nursing visits on hospitalization among medicare-reimbursed skilled home health beneficiaries. Research in Nursing & Health, 38, 257–267. https://​doi.​org/​10.​1002/​nur.​21665.CrossRef
Zurück zum Zitat Painter, M. W. (2012). Bundled payment across the US today. Connecticut. Painter, M. W. (2012). Bundled payment across the US today. Connecticut.
Zurück zum Zitat Resar, R., Griffin, F. A., & Haraden, C., Nolan, T. (2012). Using care bundles to improve health care quality. Massachusetts. Resar, R., Griffin, F. A., & Haraden, C., Nolan, T. (2012). Using care bundles to improve health care quality. Massachusetts.
Zurück zum Zitat Rich, M. W., Vinson, J. M., Sperry, J. C., Shah, A. S., Spinner, L. R., Chung, M. K., & Da Vila-Roman, V. (1993). Prevention of readmission in elderly patients with congestive heart failure - Results of a prospective, randomized pilot study. Journal of General Internal Medicine, 8, 585–590. https://doi.org/10.1007/BF02599709.CrossRef Rich, M. W., Vinson, J. M., Sperry, J. C., Shah, A. S., Spinner, L. R., Chung, M. K., & Da Vila-Roman, V. (1993). Prevention of readmission in elderly patients with congestive heart failure - Results of a prospective, randomized pilot study. Journal of General Internal Medicine, 8, 585–590. https://​doi.​org/​10.​1007/​BF02599709.CrossRef
Zurück zum Zitat Struijs, M., Molema, & de Jong-van Til, B. (2012a). Effects of bundled payment on curative health care costs in the Netherlands : An analysis for diabetes care and vascular risk management based on nationwide claim data, 2007–2010. Netherlands: Bilthoven. https://doi.org/10.1002/9781118868799.ch18. Struijs, M., Molema, & de Jong-van Til, B. (2012a). Effects of bundled payment on curative health care costs in the Netherlands : An analysis for diabetes care and vascular risk management based on nationwide claim data, 2007–2010. Netherlands: Bilthoven. https://​doi.​org/​10.​1002/​9781118868799.​ch18.
Zurück zum Zitat Struijs, J. N., de Jong-van Til, J., Lemmens, L., Drewes, H., de Bruin, S., & Baan, C. (2012). Three years of bundled payment for diabetes care in the Netherlands: Impact on health care delivery process and the quality of care. Netherlands: Bilthoven. Struijs, J. N., de Jong-van Til, J., Lemmens, L., Drewes, H., de Bruin, S., & Baan, C. (2012). Three years of bundled payment for diabetes care in the Netherlands: Impact on health care delivery process and the quality of care. Netherlands: Bilthoven.
Zurück zum Zitat Tsasis, P., Evans, J. M., & Owen, S. (2012). Reframing the challenges to integrated care: A complex-adaptive systems perspective. International Journal of Integrated Care, 12. Tsasis, P., Evans, J. M., & Owen, S. (2012). Reframing the challenges to integrated care: A complex-adaptive systems perspective. International Journal of Integrated Care, 12.
Zurück zum Zitat Tsiachristas, A., Waters, B. H., Adams, S., & a, Bal, R., Mölken, M.P.M.M.R., . (2014). Identifying and explaining the variability in development and implementation costs of disease management programs in the Netherlands. BMC Health Services Research, 14, 518. https://doi.org/10.1186/s12913-014-0518-0.CrossRef Tsiachristas, A., Waters, B. H., Adams, S., & a, Bal, R., Mölken, M.P.M.M.R., . (2014). Identifying and explaining the variability in development and implementation costs of disease management programs in the Netherlands. BMC Health Services Research, 14, 518. https://​doi.​org/​10.​1186/​s12913-014-0518-0.CrossRef
Zurück zum Zitat Wodchis, W. P., Dixon, A., Anderson, G. M., & Goodwin, N. (2015). Integrating care for older people with complex needs: Key insights and lessons from a seven-country cross-case analysis. International Journal Integrated Care, 15, 1–28. https://doi.org/10.5334/ijic.2249.CrossRef Wodchis, W. P., Dixon, A., Anderson, G. M., & Goodwin, N. (2015). Integrating care for older people with complex needs: Key insights and lessons from a seven-country cross-case analysis. International Journal Integrated Care, 15, 1–28. https://​doi.​org/​10.​5334/​ijic.​2249.CrossRef
Metadaten
Titel
Designing Financial Incentives for Integrated Care: A Case Study of Bundled Care
verfasst von
Mudathira Kadu
Jason M. Sutherland
Lusine Abrahamyan
Walter P. Wodchis
Copyright-Jahr
2021
DOI
https://doi.org/10.1007/978-3-030-69262-9_55

Premium Partner