Payment Models

MITRE works with CMS to find new ways to pay for and deliver care. We test innovative payment and service-delivery methods and evaluate models related to quality of care and changes in spending.
Doctor having a discussion with senior citizen near computer system.

Take the example of "bundled payment," a promising new model. Bundled payment has the potential to drive improvements in healthcare outcomes and lower costs while maintaining quality of care. It provides a single payment to multiple providers for an entire episode of care—that is, treatment for a specific medical condition during a set period.

The bundled payment amount is predetermined. Financial rewards flow to providers who generate savings over the course of the patient's treatment, which might include care across multiple care providers and settings. The bundled payment method may therefore incentivize care redesign by holding provider teams accountable for clinical costs, quality, and outcomes and rewarding better care coordination. By contrast, traditional fee-for-service payment reimburses a provider for each service performed. This payment method rewards providers based on the volume of services provided, rather than the efficiency and quality of those services.

MITRE helps participants in bundled care arrangements better understand the key competencies and resources required to succeed under those arrangements.

Centers

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Read our fact sheet to learn more about MITRE’s CMS Alliance to Modernize Healthcare.