Medicare initiated the Bundled Payments for Care Improvement (BPCI) that ensures facilities enter payment arrangements that include financial and performance outcomes for episodes of care. These outcomes lead to higher quality and lower cost to Medicare. Previously Medicare would make separate payments to providers for each service provided during a single course of treatment leading to fragmented care and outcomes (CMS, 2016). Patients have the right to price transparency and what is included in bundled services or a single fee that accounts for several components to care.
Patients can always choose which providers or facilities to obtain care through regardless of participating status with BPCI initiatives. Patients will retain their full Medicare benefits regardless. The redesign is to improve quality of care while lowering the cost of care to Medicare.
Bundled Payment Process
Patients who private pay for services may benefit from bundled payments as it allows for more timely allowance to prepare financially for services. Private pay patients can expect a $399 facility fee that includes imaging, medication and supplies during the procedure in addition to the separate procedure fee. Patients have the choice of what facility they would like to receive treatment from.
CMS (2016). Bundled Payments for Care Improvement Initiative (BPCI). Retrieved July 1, 2018 from https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-04-18.html