By Bob Herman
Remedy Partners, a company that helps hospitals and physicians with bundled payment programs, has raised $50 million from Bain Capital Ventures. The investment signals a growing interest in fixed-cost, episode-based care.
Bundled payments—predetermined amounts of money paid to providers to cover procedures and services over a set period of time—are a major component of the Affordable Care Act’s push to reform the financing of healthcare. HHS said this year that by the end of 2018, it wants half of all Medicare payments to be tied to value-based models, such as bundled payments and accountable care organizations. Those models have been encouraged as ways to boost care coordination and quality while reducing costs and moving away from fee-for-service payments.
The most aggressive demonstration of episodic payments is Medicare’s Bundled Payments for Care Improvement program, which went live in 2013. Hospitals and doctors voluntarily chose up to 48 different clinical episodes for which they would receive a bundled payment from Medicare.
The episodes begin at the hospital treatment and end from 30 to 90 days after the patient leaves the hospital, depending on the provider’s choice. Providers are at risk for the costs of any care that is delivered outside the fixed payment. More than 900 hospitals and physician groups are participating in BPCI as of May 2015.
