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Am J Obstet Gynecol ; 223(4): 538-542.e1, 2020 10.
Article in English | MEDLINE | ID: mdl-32531215

ABSTRACT

Ineffective healthcare delivery and expenditures associated with the traditional fee for service in-person models have turned attention toward alternative payment models as a means of enhancing healthcare quality in the United States. Bundled care payment models are a form of alternate payment models that provide a single reimbursement for all services rendered for an episode of care and have been developed extensively in primary care settings with limited literature in urogynecology. We describe the process used to create a bundled care payment model for women seeking care in a subspecialty clinic for pelvic floor disorders in partnership with our safety net insurer. The process included estimation of prior average spend, the design of an integrated practice unit, creation of pelvic floor pathways, approximation of utilization rates, and estimation of reimbursement and expenses.


Subject(s)
Health Care Costs , Patient Care Bundles , Pelvic Floor Disorders/therapy , Quality of Health Care , Reimbursement Mechanisms , Diagnostic Techniques, Obstetrical and Gynecological , Diagnostic Techniques, Urological , Female , Gynecologic Surgical Procedures , Humans , Office Visits , Pelvic Floor Disorders/diagnosis , Telemedicine , United States , Urologic Surgical Procedures
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