How Bundled Payments Could Change Spine Surgery for Medicare Patients

The Experiment

Medicare has been exploring innovative payment models for medical services. One such initiative is the Bundled Payments for Care Improvement Advanced (BPCI Advanced), launched in 2018. This program includes spine surgeries performed outside of hospitals.

How It Works

• Single Payment: Instead of billing for each service separately, a fixed amount is paid for the entire procedure.
• Goals: To save money and improve care.

Does It Work?

The big question remains: Does BPCI Advanced deliver on its promises?

• Outpatient Surgeries: These make up the majority of hospital surgeries, but few value-based payment programs have targeted them.
• Uncertain Outcomes: It's still unclear if bundled payments reduce spending or improve quality for outpatient surgery.
• Future Plans: Despite the uncertainty, there are plans to expand this model.

Why It Matters

If bundled payments work, they could transform healthcare, making it more affordable and higher quality. But if they don't, it could be a step backward.

The Bottom Line

It's crucial to monitor this experiment closely. After all, it's our healthcare system at stake.