Centers of Excellence & Bundled Payment
CHANGING INCENTIVES changes care
Costs for episodes of care can vary significantly around our state. For example, based on an analysis of Alliance member data, the median cost of knee replacements at Maine hospitals ranges from $30,000 to $50,000, and studies suggest there is little or no correlation between cost and quality.
In addition to the wide variation in cost, financial incentives in our current fee-for-service system reward the volume of services delivered rather than well-coordinated, safe care with the best outcomes.
To address these issues, the Healthcare Purchaser Alliance of Maine is working to create episode-based bundles of care that will be delivered at the highest quality centers of excellence. Purchasers will be able to pay one upfront payment for all the services associated with an episode of care. This approach has been shown to lower costs, improve outcomes, and enhance patients’ experience of care.
In markets where centers of excellence are being utilized, purchasers are realizing significant savings on the highest quality services. Based on programs implemented by other coalitions and purchasers, the Alliance believes that centers of excellence and bundled payment programs create the right incentives to promote high-quality, efficient, coordinated care that can be purchased at a competitive price.