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Bundled payment model proposed for colorectal cancer screening
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The American Gastroenterological Association has announced a model for bundled colonoscopy payments.
Geared to colonoscopy for colorectal cancer (CRC) screening, the model is intended to educate gastroenterologists about value-based reimbursement, including contracts with payors, purchasers and risk-bearing organizations. The model includes services and supplies provided during pre-procedures, day-of procedures and the day after a colonoscopy.
“Developing and negotiating bundled payments is one option in the transition to value-based care,” John I Allen, MD, MBA, AGAF, AGA Institute president-elect and an author of the model, said in an association statement.
The model offers payment negotiation scenarios and guidelines to physicians and group practices, including the possibility of poor preparation, incomplete procedures and post-polypectomy bleeding.
Citing “inconsistent interpretation of what constitutes a preventive service under the Affordable Care Act,” the association said that negotiating a bundled payment may enable physicians to demonstrate “their commitment to patient-friendly CRC services in advance of potential future changes in reimbursement.”
Disclosure: Researcher Worthe S. Holt Jr., MD, is a vice president at Humana.
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