Our friends at Boyd & Nicholas, "The Cost Report People" provide a weekly newsletter that is a nice overview of issues affecting home care.  This week they included a nice summary of a story in Healthcare Finance News about bundled payments.  Usually we're upbeat on the Ankota blog, but this story doesn't share the best news.  My guess is that when you have one organization responsible for managing care and managing a budget (like Keiser or the VA) they figure it out, but when you give money to one party and expect them to share it fairly that it's going to be tough...

Cutting healthcare cost with bundled payments proves difficult

Originally in Healthcare Finance News, November 8, 2011, summarized by Boyd and Nicholas December 7, 2011
 
Bundling payments to providers as a means to cut healthcare costs is proving harder to do than originally anticipated, according to a new study from non-profit research organization Rand Corp.
 
The Rand study examined the first three years of one of the major efforts to test the concept of bundled payments:  The PROMETHEUS Payment project launched by the Health Care Incentives Improvement Institute.  Results of the study will be published in the November issue of Health Affairs.
 
... the project is intended to show that bundling payments to doctors, hospitals and other health providers into a single payment would encourage the different providers to work together to both treat all aspects of particular procedures and diseases while eliminating unnecessary care.
 
But the Rand study found that three years after launch, no bundled payments had been made and no payment contracts for bundled payments have been executed.  Although all parties involved with the effort are committed to its success, researchers say the slow progress underscores the challenges such complex payment reforms must overcome. ...
 
The adoption of bundled payments was slowed by a number of different issues including which health problems should be included in a payment bundle, as well as difficulty convincing providers that the cost cutting measures that would be required wouldn't compromise quality of care.