Payers and employers unmoved by bundles
The model is still too unproven to get behind
In the last of a trio of surveys exploring attitudes toward the bundled care model, payers and employers indicated that they are not sold on it.
Booz & Company surveyed 64 employers and 58 health plans of varying sizes. The first two surveys in the bundled care trilogy queried consumers and providers. The consumer survey indicated that they liked the bundled care model, but the provider survey found that providers were lukewarm about them.
[See also: Poll finds consumers like bundled care]
In the third survey, only 5 percent of employers said they were actively pursuing bundled care initiatives, while 80 percent of those surveyed said they were unaware of and/or not interested in bundled care. All the employers actively pursuing bundled care employ 1,000 or more workers. Sixty percent of the survey sample included companies with 50 or fewer employees.
The employers pursuing bundles are large, and likely self-insure, which means they are more apt to explore models like bundles in order to try to influence how the costs of care are managed, said Minoo Javanmardian, PhD, a partner with Booz who works with the global management and strategy consulting firm’s healthcare clients. Smaller employers just do not have the scale to experiment, she said, but they may embrace the model if the larger employers can demonstrate that bundles reduce healthcare costs and improve quality of care.
Payers, much like providers, are looking at a complete overhaul of their operations in order to transform from fee-for-service to value-based care models, so they are more cautious about adopting the bundled care model in the long term.
According to the survey results, payers are as interested in pursuing bundles (31 percent have and 47 percent are interested) as they are other new care delivery and payment options, such as patient-centered medical homes and accountable care organizations.
[See also: Providers tepid on bundles]
“The payers all recognize that the world is changing and they need to stay relevant,” said Javanmardian. “The question becomes how do they do that in a viable manner.”
“One way or the other, unless you believe that we can keep living with this double-digit increase in the cost of care while quality is not improving … you have to start thinking about … a different business model,” she said.
Large payers are the ones that have the scale to take the lead, she said, and the others will follow.
