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Creating a bundled care payment model for treatment of pelvic floor disorders: introducing value into urogynecology

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Abstract Ineffective healthcare delivery and expenditures associated with traditional fee for service in-person models have turned attention towards alternative payment models as a means of enhancing healthcare quality in the… Click to show full abstract

Abstract Ineffective healthcare delivery and expenditures associated with traditional fee for service in-person models have turned attention towards 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 pelvic floor disorders subspecialty clinic 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.

Keywords: payment model; pelvic floor; care payment; payment; bundled care

Journal Title: American Journal of Obstetrics and Gynecology
Year Published: 2020

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