by Grace-Marie Turner | Forbes | June 1, 2020 |
Bundled payments are a good idea, until they aren’t—for patients.
The idea of paying a combined price rather than piecemeal for a routine medical treatment or procedure has gained traction as a way of driving efficiency. You wouldn’t want to buy a car by ordering a carburetor, ignition, fuel tank, braking system, etc.
But when the government controls the payment system, as it does in Medicare, bad decisions can result, with little transparency and choice for patients and a lack of accountability for providers to make sure patients receive personally appropriate care.
An egregious example of this is affecting some patients undergoing dialysis treatment. Medicare began providing a bundled payment for dialysis treatment in 2011. In 2021, the average Medicare bundled rate for a dialysis treatment is about $253 to cover the cost of the dialysis treatment as well as dialysis-related drugs and laboratory tests. The actual rate can vary depending on the region and other factors.