Bundled Payments in Healthcare: How Envision Healthcare is Leading the Way in a New Payment Philosophy

Posted on Fri, Dec 04, 2015
Bundled Payments in Healthcare: How Envision Healthcare is Leading the Way in a New Payment Philosophy

By Daniel Castillo, MD
Executive Vice President, Evolution Health

You know how insurance customers save money by bundling various types of coverage, or communications customers can get a discount combining phone, cable television and internet services? The same principle is now being used for healthcare.

The federal government has launched a new bundled payment initiative designed to manage costs for Medicare patients. Under the program, different organizations – for example, hospitals, post-acute care companies, private physicians and/or therapists – agree to payment arrangements that include financial and performance accountability for episodes of care. The aim is to provide higher quality, coordinated care across the spectrum, all at a lower cost for Medicare and the patient. So basically, you have improved outcomes and lower costs by having healthcare organizations work together to combine services and set pricing ahead of time.

Envision Healthcare is in a unique position to lead the way in this initiative – after all, Envision is the parent of EmCare, a hospital-based company; AMR, a pre-hospital care company; and Evolution Health, a post-acute care company. Envision already focuses on quality of care, and with its complete continuum of services, our company is at the forefront of bundled care.

Currently, the initiative includes four broadly-defined models of care. In two of them, Envision takes on risk by assuming responsibility for managing the cost of a portion of a patient’s care episode. In one of the models, care begins with a hospital admission (from an EmCare hospitalist) and continues through the post-acute recovery (via Evolution Health). AMR often provides community paramedics to manage any gaps in care as well. In a different model, care starts after the patient is discharged from the hospital. As Evolution Health patients, they have access to the Medical Command Center which utilizes Evolution’s nurse navigators, EmCare physicians and AMR caregivers.

The bundled payment initiative is important not just for the government and patients, but for Envision Healthcare. It’s a way to integrate Envision’s array of services in a more involved way. It’s all three of our companies – AMR, EmCare and Evolution Health – working together to improve value and care for our patients. Currently, Envision Healthcare is enacting the bundled payment philosophy in 34 different programs across the country. That number is certain to grow.

When healthcare moved from the fee-for-service model to the value-based purchasing model, Medicare put the emphasis on quality rather than volume. The natural byproduct of lower costs and improved care is improved patient satisfaction and reduced admissions. Healthcare organizations offer better value, which means more meaningful reimbursement. And the patient is happy to reduce costs and their length of stay in the hospital.

Envision Healthcare draws from a diverse team of clinicians to provide the right care when it’s needed, wherever the patient resides. With our scope of expertise and scale of operations, we are uniquely positioned to provide bundled payment solutions.


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