AGA Offers Bundled Payment Model for Gastroenterologists

The bundled payment model encourages health systems to provide high quality, better-coordinated care at a lower cost for Medicare beneficiaries. It’s no wonder, then, why the American Gastroenterological Association (AGA) has developed a colonoscopy bundled payment model to help gastroenterologists achieve value-based health outcomes.

“Developing and negotiating bundled payments is one option in the transition to value-based care,” said John I. Allen, MD, MBA, AGAF, AGA Institute president elect, and an author of the colonoscopy bundle model. “Practices that perform procedures in high-quality, cost-efficient settings will be rewarded, and can use a bundled payment mechanism for negotiation and alignment with healthcare systems.”

The bundled payment model focuses on colonoscopies for colorectal cancer (CRC) screening, diagnosis, and surveillance. It encompasses a patient’s entire episode of care, from their pre-consultation to the post-colonoscopy period. The framework also assists practitioners when negotiating payments with facilities or insurance companies. The AGA says that the bundled payment model will help gastroenterologists in providing truly value-based care.

One organization that recently made the decision to move toward bundled payments is The Elliot Health System (EHS) in New Hampshire. They say that bundling costs provides patients with higher transparency about what they are paying for, and lowers their out-of-pocket costs. Rick Elwell, CFO at EHS, for example, said that colonoscopies average just shy of $2000 per procedure under the new model. Unbundled, that same procedure doubles in cost. An extra benefit, he said, is the reduction in paperwork and billing.

“This innovation will create price transparencies, so patients understand up front exactly what their healthcare costs will be, and will transform how patients and employers pay for healthcare in New Hampshire in the future,” said Dr Rick Phelps, president and COO at EHS. “We are confident that what we’re about to unveil will meet the needs of businesses and patients looking for value in healthcare, and create a real solution for escalating healthcare costs for everyone.”

Around the Web

Bundled Payments Come to Gastroenterology [Medical Xpress]

Elliot Hospital Unveils Bundled Billing Plan to Help with Costs [New Hampshire Union Leader]