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Bowen Addresses Bundled Payments

Wolters Kluwer Health Reform WK-EDGE
October 2014

Charlotte Health Care Member Carol Bowen was quoted in Wolters Kluwer’s Health Reform WK-EDGE on October 21, in the top story “Strategic Perspectives: Do bundled payments improve care and lower costs?” The piece examines bundled payments, which, in large part due to a push from the Patient Protection and Affordable Care Act, are being considered and tested as alternatives to traditional fee-for-service payment models. The article identifies strengths and weaknesses of bundled payment systems.

“According to Bowen, separate ownership can lead to challenges in complying with laws like the Health Insurance Portability and Accountability Act (HIPAA) (P.L. 104-191). Bowen said coordination creates HIPAA compliance issues because, ‘at this time, many post-acute care providers are separately owned and operated from acute care hospitals and, thus, may not share electronic medical record systems. As a result, providers participating in a bundled care arrangement who do not share a patient medical record system will have difficulty in coordinating patient care, which is so critical to these arrangements. In addition, lack of a common patient medical record database may mean that historical data across the complete care continuum is not available to use when structuring a bundle, so providers may find it difficult to determine where risks are. If there is not a common medical record database, there are technology challenges to ensuring HIPAA and state law compliance with sharing medical information electronically.’”