A new report by the Government Accountability Office (GAO) compares voluntary and mandatory bundled payment models, and may offer a hint as to which one comes out ahead.

The GAO examined six Medicare episode-based payment models that were in place in early 2018, the lone mandatory model of which was Comprehensive Care for Joint Replacement (CJR). Participants in these models tended to be located in urban areas and had higher episode volume than non-participating Medicare providers.

Providers in the voluntary models were attracted by the greater participant incentives compared to mandatory models, including the ability to choose episodes that offered opportunities to implement care redesign and earn performance bonuses. Conversely, the report found that, because the mandatory models require participation, they offer a more representative sample of providers. This allows for more generalizable results, greater financial risk notwithstanding.

Since models like CJR encourage a quicker transition from traditional Medicare to value-based care, Health and Human Services Alex Azar has made known his preference for the mandatory approach… and taken in turn with the GAO findings, would indicate that we’ll be seeing more mandatory models going forward, says MedBen President & CEO Kurt Harden.

“The GAO report makes the case that while voluntary models have their place for testing feasibility and novel concepts, mandatory models offer more useful information for improving quality and savings,” Harden said. “It may not make participants happy, but if you want to control costs, mandatory is the way to go.”

Regardless of the direction bundled payment models do ultimately take, MedBen Analytics is ready to help hospitals, health systems and other providers achieve positive results from their participation. We work with both voluntary and mandatory models, and the insights offered through our innovative reporting software platform will enable your organization to ensure the highest level of care while unlocking profit potential.

If you’d like to see a demonstration of our system or want additional information about MedBen Analytics, please call Harden at 888-633-2364 or email kharden@medben.com.