Bundled Payments are integral to VBR success

"Competencies around data use ranked highest in likelihood of enabling success under value-based payment. In particular, analytical support (business intelligence and actuarial), use of consistent quality care measures, and ability to monitor adherence to medically recommended regimens at the patient level ranked highest in enabling organizations to take on risk-based arrangements." -HFMA's Executive Survey: Value-Based Payment Readiness, HFMA, May 2015

Bundled payment models focus on value to control costs while also improving patient solutions and outcomes. In their definitive article, "Redefining Health Care: Creating Value-Based Competition on Results," Michael E. Porter and Elizabeth Olmsted define value as equaling patient outcomes/cost, noting that "individual services rarely produce health outcomes; it takes a bundle of services over time."

Bundled payments require providers to:

  • Address business + effectiveness risks by delivering services for a specific problem
  • Have a full grasp/understanding for an episode of care
  • Develop competencies around data use ranked highest in likelihood of enabling success under value-based payment models

Leveraging data is key in a bundled payment scenario to:

  • Unlock access to your claims data
  • Use claims analytics to develop your bundled payment strategy
  • Collaborate transparently with your provider network
  • Manage three levels of analytics
  • View performance by practice and provider
  • Understand specific member scenarios and identify potentially avoidable costs
  • Review provider benchmarking report for peer-to-peer analysis
  • Operationalize your bundled payment strategies

Episode Consulting and Episode Analytics

nThrive's Episode Consulting and Episode Analytics tools and services are designed to help health care providers and payors prepare for and manage significant changes in payment structure resulting from value-based reimbursement payment models. nThrive offers an end-to-end approach to implementing bundled payment methodologies and managing reimbursements under an episode-based payment system. Comprehensive readiness assessments, financial and clinical analysis and consultative engagements can deliver complete visibility across a patient's full episode of care. We empower hospitals and health care organizations with actionable insight to support strategies that mitigate risk.

nThrive Episode Manager is a web-based tool designed to manage the complex process associated with episode management in a bundled payment scenario.

Episode Manager

Efficiently manage, track and reconcile bundled payments

Take the guess work out of managing bundled payments. Reprice episodes on a continual, prospective basis, taking into account the treatment phases, contract terms, global rates and thresholds to ensure you receive the appropriate reimbursement.

Key functionality:

  • Track claims by episode phases; track reimbursement by claim and case level

  • Bundle claims based on varying reimbursement methods within each phase

  • Generate advanced reports designed specifically for episode management

  • Confirm accurate reimbursement

nThrive Retrospective and Prospective Bundled Payment solutions, MIPS reporting services (for existing customers) and Advanced APM analytics can bring your hospital or health care organization to the next level by maximizing value-based reimbursements.

Just getting started?

Assess your risk-readiness with the nThrive VIP (Value-Index Position) Scorecard to take your first step towards increasing your margins while maintaining costs.

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