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In a statement issued in response to the GAO report, Amgen said it is concerned that implementing a bundled payment system "without appropriate case-mix adjusters and quality safeguards could introduce financial incentives to underutilize services and could decrease the quality of care".
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Geisinger Health System also implemented a bundled payment model called ProvenCare that led to a 10% decrease in hospital re-admissions, shorter hospital stays, and reduced overall healthcare fees.
However, these statements do not appear to consider the nontrivial costs of monitoring and the education activities required to implement a bundled approach in a new setting.
In 2006, Japan implemented a bundled payment policy to cover outpatient hemodialysis therapy with the stated aim of lowering dialysis payments by 4%.
Conclusions Surgical programs that implement a bundled intervention including both nasal decolonization and glycopeptide prophylaxis for MRSA carriers may decrease rates of surgical site infections caused by S aureus or other Gram positive bacteria.
Similarly, two other studies showed a beneficial effect of implementing a bundle for VAP prevention, including routine care for tracheal cuff [34, 35].
The cost of implementing a bundle in Australia is unknown.
A high quality study that estimates the costs of implementing a bundle would increase the usefulness of this modelling.
Similarly, two other studies showed a beneficial effect of implementing a bundle for VAP prevention, including routine care for tracheal cuff [ 34, 35].
In 2007, the Dutch government compelled hospitals to implement a bundle concerning medication reconciliation at hospital admission and discharge.
Reducing ventilator-associated pneumonia in intensive care: impact of implementing a care bundle.
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