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Delivery System Innovation

Applied research and implementation science agenda to spread evidence-based practices and test new models of care delivery and payment.

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Database of Innovative Care Delivery and Payment Approaches

Sample of bundled payment, accountable care organization, and the patient-centered medical home programs

The Patient Protection and Affordable Care Act, signed into law in March, 2010 included several provisions to test innovative health care delivery and payment approaches. Three of these pilot programs that could be relevant to hospitals are bundled payments, accountable care organizations, and the patient-centered medical home.  The law calls for the establishment of a national pilot program on payment bundling for the Medicare program by 2013 and a Medicaid bundling demonstration program by 2012. The law also calls for the creation of an ACO program by January 1, 2012 and the establishment of community-based interdisciplinary, interprofessional 'health teams' to support primary care providers in the creation of medical homes.

HRET created this database to aid hospitals in understanding the scope of existing bundled payment, accountable care organization, and patient-centered medical home programs. This database is intended to provide a sample of public and private sector programs.  We found that several patient-centered medical home programs have been established, perhaps because the concept has existed much longer and has been bolstered by state involvement and the development of PCMH standards. ACO and Bundled payment, which are relatively newer concepts had fewer existing programs.

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