Catalyst for Payment Reform

Toolkit: Advancing Effective Bundled Payment

Toolkit: Advancing Effective Bundled Payment

This toolkit contains evaluation questions and detailed specifications to meet the needs of employer-purchasers considering or reviewing bundled payment options.

Bundled payment accounts for only 2% of commercial health care dollars, despite evidence showing it has the potential to maintain or reduce cost while increasing quality.  And there is a bevy of bundled payment administrator solutions for employers and other health care purchasers to consider.

In 2019, CPR convened a group of four employer-purchasers and a subject matter expert formerly of McKinsey & Company for a 12-month collaborative committed to advancing effective bundled payment.  Based on the insights and needs of the employer-purchasers, CPR developed a toolkit for evaluating the various marketplace options and piloted it with 10 health plans, centers of excellence (COE) vendors, and “hybrid” vendors (i.e., vendors that can operate under a health plan or as a COE vendor) in 2020.  While the summary scorecards of the 10 administrators are an exclusive benefit for CPR member organizations, CPR is releasing the toolkit publicly to help set an industry standard and push the marketplace to better meet the needs of employer-purchasers.

The evaluation framework outlines best practice criteria in two overarching categories: the Purchaser-Administrator Relationship and Bundle Characteristics. CPR introduced the framework during our July 2020 Bundled Payment Virtual Summit, available for viewing on-demand.

Want to see where the marketplace stands within the framework of these specifications? Check out Bundled Payment Options in the 2020 Marketplace: A Guide for Employers and Other Health Care Purchasers.

How to use this toolkit:

This toolkit is designed for use by employer-purchasers interested in:

  1. Reviewing their health plan’s implementation of and future strategy for bundled payment, or
  2. Evaluating the offerings of a centers of excellence vendor or hybrid vendor interested in working with self-funded purchasers.

Employer-purchasers, or their consultants, can download the editable evaluation framework, customize it to their needs, and send to external partners for responses.  Note, we recommend against substantial customization, as purchaser alignment sends a consistent signal to the marketplace.  Once users receive the responses, they can compare them to CPR’s specifications.  CPR also encourages health plans, providers, and vendors to use the toolkit to internally evaluate their programs against employer-purchaser expectations.

As a health care purchaser, you can log in to get FREE access!

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Type: Toolkit



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