Study offers framework for bundled payment model for breast cancer screening, imaging services

August 17, 2016

Researchers from the Harvey L. Neiman Health Policy Institute suggest mammography may present an opportunity for the expanded use of bundled payments in radiology. Their study points out that breast cancer screening provides a framework for radiologist-led bundled payment models that can be implemented with different services depending upon a practice's specific patient panel. The researchers used Medicare claims and data from a private health system to develop a bundled payment model for mammography. Bundles developed with a screening mammography event included several downstream diagnostic breast imaging services during a 364-day episode window. The authors found that breast cancer screening had the benefit of well-established practice parameters and structured reporting that could reduce the variation. The study doesn't propose a price CMS or other payers should pay for a breast cancer screening episode, but offers a framework for individual practices to build a model with a payer based on their own individual population and practice.
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