Bundling payments reduces health care spendingA new report from the Agency for Healthcare Research and Quality (AHRQ) found that health care spending and the use of health care services were reduced by the introduction of "bundled payments"—a system in which health care providers are reimbursed the expected cost of patient services in a single payment rather than receiving individual reimbursement for each service. Evidence for the impacts of bundled payments on quality measures, however, was inconsistent and generally had small effects. Furthermore, the researchers found the overall evidence on bundled payments to be low, because most of the studies examined bundled payments for single institutions and many had quality concerns. However, according to lead researcher Peter S. Hussey, PhD, of the RAND Evidence-based Practice Center, the report provides policymakers some support that bundling payment is likely to be an effective strategy. And while the method's effects on quality are less certain, the evidence does not support the worst concerns about potentially adverse effects.
The report is part of AHRQ's "Closing the Quality Gap: Revisiting the State of the Science" series. For details, go to Bundled Payment: Effects on Health Care Spending and Quality at the Effective Health Care Program Web site at http://www.effectivehealthcare.ahrq.gov.
In another report in this series, the Vanderbilt University Evidence-based Practice Center researchers found that, as a whole, the evidence on the effectiveness of quality improvement initiatives to specifically reduce health care disparities has not been clearly demonstrated, although they did find a few studies showing that quality improvement interventions affected health care disparities in certain disadvantaged populations. The study was led by Melissa L. McPheeters, PhD For details, go to Quality Improvement Interventions To Address Health Care Disparities at http://www.effectivehealthcare.ahrq.gov.