Experts push more bundled pay initiatives to curb healthcare spending

In a set of recommendations published in the New England Journal of Medicine on Wednesday, authors of a new report urge the federal government to accelerate the adoption of fee-for-service alternatives such as bundled payment programs.

Under this model, payers would pay a fixed amount to providers — including post-acute and rehabilitation facilities — for a bundle of services. This strategy has been promoted among long-term care payment experts.

Healthcare policy experts assembled by the liberal Center for American Progress (CAP) said that while the Affordable Care Act is expected to greatly reduce Medicare spending, overall healthcare spending is still growing at an unsustainable rate.

Panelists promoted a payment model of self-regulation, under which public and private payers would negotiate payment rates with providers. The rates would be binding for all payers and providers in a given state.  Additionally, the CAP panelists encouraged more rapid and widespread use of competitive bidding programs for all commodities. Competitive bidding programs have elicited mixed reactions from long-term care providers.

Panelists included Ezekial Emanuel, M.D., an Obama administration healthcare adviser; Peter Orszag, former director of the Office of Management and Budget; Donald Berwick, M.D., former administrator of the Centers for Medicare & Medicaid Services.

Click here to read the full proposal.