Health Plan Bundled Payment Reform Evaluation Framework

Looking to evaluate your health plan’s bundled payment program?

The Reform Evaluation Framework (REF) for Health Plan Administered Bundled Payment Programs evaluates the program’s impact on cost, quality, utilization and member experience. Impact is measured relative to a comparison group comprising the purchaser’s plan members who sought care from providers who are not paid under a bundled payment contract. This report allows the purchaser to select from 7 of the most commonly bundled episodes of care.


  1. Definitions: Provides definitions of terms, cost and quality measures
  2. Bundle Report – Purchaser: Worksheet for evaluating impact of the bundled payment program on purchaser’s plan members
  3. Bundle Report – Book of Business: Worksheet for evaluating impact of the bundled payment program for health plan’s book of business

By using this tool you will learn:

  • How has the implementation of a bundled payment contract impacted cost, quality and experience outcomes for plan members?
  • How do those outcomes compare to plan members who sought care from a non-bundled provider?
  • What are the cost of care savings that accrue both from the bundled payment itself, and from surgeries avoided through pre-procedural evaluation?

Questions? Reach out to Julianne McGarry at

Evaluation Framework
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