Bundled Payment vs. Fee-for-Service: Impact of Payment Scheme on Performance

Published Online:https://doi.org/10.1287/mnsc.2016.2445

References

  • Abelson R, Cohen S (2014) Sliver of Medicare doctors get big share of payouts. New York Times (April 9), http://www.nytimes.com/2014/04/09/business/sliver-of-medicare-doctors-get-big-share-of-payouts.html.Google Scholar
  • Agrawal VV, Bellos I (2016) The potential of servicizing as a green business model. Management Sci. 63(5):1545–1562.LinkGoogle Scholar
  • Arrow KJ (1963) Uncertainty and the welfare economics of medical care. Amer. Econom. Rev. 53(5):941–973.Google Scholar
  • Ata B, Killaly BL, Olsen TL, Parker RP (2013) On hospice operations under Medicare reimbursement policies. Management Sci. 59(5):1027–1044.LinkGoogle Scholar
  • Brady T, Davies A, Gann DM (2005) Creating value by delivering integrated solutions. Internat. J. Project Management 23(5):360–365.CrossrefGoogle Scholar
  • Burns J (2013) Bundled payments. Hospitals Health Networks/AHA 87(4):26–31.Google Scholar
  • Cachon GP (2003) Supply chain coordination with contracts. Graves S, de Kok T, eds. Handbook in Operations Research and Management Science: Supply Chain Management (Elsevier, New York), 229–340.CrossrefGoogle Scholar
  • Carlton DW, Perloff JM (1990) Modern Industrial Organization (Scott Foresman/Little, Brown Higher Education, New York).Google Scholar
  • Dahl P, Horman M, Pohlman T, Pulaski M (2005) Evaluating design-build-operate-maintain delivery as a tool for sustainability. Construction Res. Congress 1–10, http://ascelibrary.org/doi/abs/10.1061/40754(183)27.Google Scholar
  • Dartmouth Atlas Project, PerryUndem Research/Communication (2013) The Revolving Door: A Report on U.S. Hospital Readmissions (Robert Wood Johnson Foundation, Princeton, NJ).Google Scholar
  • Dobson A, DaVanzo JE (2013) Medicare payment bundling: Insights from claims data and policy implications. Report, Dobson DaVanzo & Associates, Vienna, VA. http://www.aha.org/research/reports/12bundling.shtml.Google Scholar
  • Dranove D (1996) Measuring costs. Sloan FA, ed. Valuing Health Care: Costs, Benefits, and Effectiveness of Pharmaceuticals and Other Medical Technologies, Chap. 4 (Cambridge University Press, Cambridge, UK), 61–76.Google Scholar
  • Dyrda L (2012) 10 steps to negotiate smart bundled payment deals for orthopedic surgery. Becker’s Spine Review (June 11), http://www.beckersspine.com/orthopedic-spine-practices-improving-profits/item/12220-10-steps-to-negotiate-smart-bundled-payment-deals-for-orthopedic-surgery.Google Scholar
  • Ellis RP, Fernandez JG (2013) Risk selection, risk adjustment and choice: Concepts and lessons from the Americas. Internat. J. Environment. Res. Public Health 10(11):5299–5332.CrossrefGoogle Scholar
  • Feder J (2013) Bundle with care—Rethinking Medicare incentives for post–acute care services. New England J. Medicine 369(5):400–401.CrossrefGoogle Scholar
  • Fuloria PC, Zenios SA (2001) Outcomes-adjusted reimbursement in a health-care delivery system. Management Sci. 47(6):735–751.LinkGoogle Scholar
  • Gan X, Sethi SP, Yan H (2004) Coordination of supply chains with risk-averse agents. Production Oper. Management 13(2):135–149.CrossrefGoogle Scholar
  • Guajardo JA, Cohen MA, Kim S-H, Netessine S (2012) Impact of performance-based contracting on product reliability: An empirical analysis. Management Sci. 58(5):961–979.LinkGoogle Scholar
  • Ha AY (2001) Supplier-buyer contracting: Asymmetric cost information and cutoff level policy for buyer participation. Naval Res. Logist. 48(1):41–64.CrossrefGoogle Scholar
  • Hoeffding W (1963) Probability inequalities for sums of bounded random variables. J. Amer. Statist. Assoc. 58(301):13–30.CrossrefGoogle Scholar
  • Huckfeldt PJ, Sood N, Escarce JJ, Grabowski DC, Newhouse JP (2014) Effects of Medicare payment reform: Evidence from the home health interim and prospective payment systems. J. Health Econom. 34:1–18.CrossrefGoogle Scholar
  • Hussey PS, Mulcahy AW, Schnyer C, Schneider EC (2012) Closing the quality gap: Revisiting the state of the science (Vol. 1: Bundled payment: Effects on health care spending and quality). Technical report, Agency for Healthcare Research and Quality, Rockville, MD.Google Scholar
  • Jain SH, Besancon E (2013) Reimbursement: Understanding how we pay for health care. An Introduction to Health Policy (Springer, New York), 179–187.CrossrefGoogle Scholar
  • Jiang H, Pang Z, Savin S (2012) Performance-based contracts for outpatient medical services. Manufacturing Service Oper. Management 14(4):654–669.LinkGoogle Scholar
  • Lee DK, Zenios SA (2012) An evidence-based incentive system for Medicare’s end-stage renal disease program. Management Sci. 58(6):1092–1105.LinkGoogle Scholar
  • Mayes R (2007) The origins, development, and passage of Medicare’s revolutionary prospective payment system. J. History of Medicine and Allied Sci. 62(1):21–55.CrossrefGoogle Scholar
  • McClellan M (1997) Hospital reimbursement incentives: An empirical analysis. J. Econom. Management Strategy 6(1):91–128.CrossrefGoogle Scholar
  • McKoy JM (2006) Obligation to provide services: A physician-public defender comparison. Virtual Mentor/AMA J. Ethics 8(5):332–334.Google Scholar
  • Mechanic R, Tompkins C (2012) Lessons learned preparing for Medicare bundled payments. New England J. Medicine 367(20):1873–1875.CrossrefGoogle Scholar
  • MedPAC (2013) Approaches to bundling payment for post-acute care. Report to the Congress: Medicare and the Health Care Delivery System, Chap. 3 (Medicare Payment Advisory Commission, Washington, DC), 57–88.Google Scholar
  • Newhouse JP (1996) Reimbursing health plans and health providers: Efficiency in production versus selection. J. Econom. Literature 34(3):1236–1263.Google Scholar
  • Office of Inspector General and Office of Evaluation and Inspections (2001) Medicare hospital prospective payment system: How DRG rates are calculated and updated. White paper, http://oig.hhs.gov/oei/reports/oei-09-00-00200.pdf.Google Scholar
  • Plambeck EL, Zenios SA (2000) Performance-based incentives in a dynamic principal-agent model. Manufacturing Service Oper. Management 2(3):240–263.LinkGoogle Scholar
  • Powell A, Savin S, Savva N (2012) Physician workload and hospital reimbursement: Overworked physicians generate less revenue per patient. Manufacturing Service Oper. Management 14(4):512–528.LinkGoogle Scholar
  • Pratt JW (1964) Risk aversion in the small and in the large. Econometrica 32(1/2):122–136.CrossrefGoogle Scholar
  • Rosenthal E (2013a) As hospital prices soar, a single stitch tops $500. New York Times (December 2), http://www.nytimes.com/2013/12/03/health/as-hospital-costs-soar-single-stitch-tops-500.html?pagewanted=all.Google Scholar
  • Rosenthal E (2013b) The $2.7 trillion medical bill. New York Times (June 1), http://www.nytimes.com/2013/06/02/health/colonoscopies-explain-why-us-leads-the-world-in-health-expenditures.html?pagewanted=all&_r=0.Google Scholar
  • Rosenthal E (2014) Patients’ costs skyrocket; specialists’ incomes soar. New York Times (January 18), http://www.nytimes.com/2014/01/19/health/patients-costs-skyrocket-specialists-incomes-soar.html.Google Scholar
  • Rosenthal MB, Fernandopulle R, Song HR, Landon B (2004) Paying for quality: Providers’ incentives for quality improvement. Health Affairs 23(2):127–141.CrossrefGoogle Scholar
  • Shleifer A (1985) A theory of yardstick competition. RAND J. Econom. 16-3:319–327.CrossrefGoogle Scholar
  • Sood N, Huckfeldt PJ, Escarce JJ, Grabowski DC, Newhouse JP (2011) Medicare’s bundled payment pilot for acute and postacute care: Analysis and recommendations on where to begin. Health Affairs 30(9):1708–1717.CrossrefGoogle Scholar
  • Sood N, Huckfeldt PJ, Grabowski DC, Newhouse JP, Escarce JJ (2013) The effect of prospective payment on admission and treatment policy: Evidence from inpatient rehabilitation facilities. J. Health Econom. 32(5):965–979.CrossrefGoogle Scholar
  • Studdert D, Mello M, Sage W, DesRoches C, Peugh J, Zapert K, Brennan T (2005) Defensive medicine among high-risk specialist physicians in a volatile malpractice environment. J. Amer. Medical Assoc. 293(21):2609–2617.CrossrefGoogle Scholar
  • Toffel MW (2008) Contracting for Servicizing (Harvard Business School, Boston).CrossrefGoogle Scholar
  • Tompkins C, Ritter G, Mechanic R, Perloff J, Chapman J (2012) Analysis of financial risk and risk mitigation option in the Medicare Bundled Payment for Care Improvement program. Technical report, Schneider Institutes for Health Policy and Heller School for Social Policy and Management, Brandeis University, Waltham, MA.Google Scholar
  • Weng ZK (1999) The power of coordinated decisions for short-life-cycle products in a manufacturing and distribution supply chain. IIE Trans. 31(11):1037–1049.CrossrefGoogle Scholar
  • White AL, Stoughton M, Feng L (1999) Servicizing: The quiet transition to extended product responsibility. Technical report, Tellus Institute, Boston.Google Scholar
  • Wilson R (1968) The theory of syndicates. Econometrica 36(1):119–132.CrossrefGoogle Scholar
  • Yaesoubi R, Roberts SD (2011) Payment contracts in a preventive health care system: A perspective from operations management. J. Health Econom. 30(6):1188–1196.CrossrefGoogle Scholar
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