Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/1145
Title: Using health information technology to enhance care outcome accountability through bundled payments.
Epworth Authors: Wickramasinghe, Nilma
Other Authors: Gibbings, Rima Artonian
Schaffer, Jonathan
Keywords: Health Information Technology
Care Outcome
US Healthcare System
Bundled Payments for Care Improvement
BPCI
Quality of Care
Improvements
Cost Reductions
Bundle Payment Arrangement
Mixed-Method Research Design
Design Science Research Methodology
DSRM
Categorization of Medical Procedures
Bundle Payment Encoding
Healthcare Facilities
Technology Solutions
Pay-For-Performance
P4P
Efficient Care
Preventative Services
Accountability
Chair of Health Informatics Management, Epworth HealthCare, Victoria, Australia
Issue Date: Jun-2017
Citation: Epworth Research Institute Research Week 2017; Poster 13: pp 36
Conference: Epworth Research Institute Research Week 2017
Conference Location: Epworth Research Institute, Victoria, Australia
Abstract: INTRODUCTION/BACKGROUND: To revise the cost and quality imbalance in the current US healthcare system, new models have been recommended that will tie health care reimbursement with efficient outcomes. Bundles Payments for Care Improvement (BPCI) initiatives focus on measuring the degree of success in improving quality care and reducing cost with selected organizations (Centres for Medicare and Medicaid Services, 2016). In reviewing the several models suggested through the BPCI, the focus is to determine a retrospective bundles payment arrangement that will reconcile the actual rendered care services' cost with the targeted price for a given episode of care. METHOD: The mixed-method research method utilises a design science research methodology (DSRM). The study is based on categorizing medical procedures based on predetermined bundles payments. Further, it examines the role of the developed technology solution to assist with promoting accountability. The study focuses on enabling healthcare facilities to determine bundled payment encodings and reflects the codes in the payment process. Facilities will be capable in identifying the procedural charges of clinical processes according to bundle settings. RESULTS: This is a research in progress study. The main idea of this study is to assist healthcare facilities in creating road maps prior to adopting bundled payments. Currently, the conceptual model and first parts of the technology solution have been developed and we are confident at the conclusion of the project a fully operational solution will bring the desired outcomes as well as significantly contribution to theory. CONCLUSIONS: Replacing fee-for-service with pay-for performance (P4P) is aimed at rewarding healthcare facilities who provide higher quality of care with reduced cost. The main goals of P4P include ensuring that patients receive adequate, timely, cost-effective and efficient care through improving quality of care, reducing complication episodes, and emphasizing on timely and preventive services. This environment requires sophisticated technology solutions.
URI: http://hdl.handle.net/11434/1145
Type: Conference Poster
Affiliated Organisations: University of Illinois, Chicago, USA.
Deakin University
Appears in Collections:Health Informatics

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