Hospitals

Defining the Bundle
Characteristics of Clinical Conditions Best Suited
to Payment Bundling
• Adequate prevalence, with sufficient sample size to
predict costs and show the effect of clinical
interventions
• Significant resource consumption for the Medicare
program, either from being expensive on a per-episode
basis or because of high case volume
• Adequate variation in Medicare payment to allow for
efficiency gains, but not so much variation that the risk
of multiple outlier cases outweighs the reward
• Availability of clear, evidence-based clinical care
guidelines
2012 AAMC Annual Meeting