In the context of healthcare reimbursement, what does a bundled payment entail?

A bundled payment refers to a single payment that encompasses a variety of services related to a specific treatment or condition. This payment structure is designed to streamline the billing process by consolidating multiple charges into one comprehensive fee. For instance, if a patient undergoes surgery, the bundled payment might include the costs associated with pre-operative consultations, the surgical procedure itself, and any post-operative care or follow-up visits.

This approach incentivizes providers to coordinate care more effectively, as they receive a fixed amount regardless of the number of services rendered, promoting efficiency and reducing unnecessary procedures. It also helps to simplify the reimbursement process for both providers and payers, making it easier to understand costs associated with specific treatments.

In contrast, payments for unrelated services, consultations only, and advance payments for services do not reflect the bundled payment model, which specifically integrates multiple related services into one payment for a defined patient journey.