But under the bundled payment system, providers get the same payment for providing dialysis services, whether they provide ESAs or not.

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While there are several proposed bundled payment types, including retrospective and prospective types, the onus of financial responsibility is shifting to the ACO.

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The GAO also questioned whether there was enough data to figure out how much the bundled payment should be adjusted to include these oral medicines.

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Though bundled payment efforts have been tested in the past, Blum said none have been as broad or garnered as much participation from providers of medical care, particularly hospitals and post-acute care providers.

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Recently, I had a conversation with a few of my colleagues about whether we could accept a bundled payment for patients with thyroid cancer, one of the cancers I commonly treat in my practice as a surgeon.

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Whether it is through an accountable care organization (ACO) or bundled payment to a patient-centered medical home, insurance companies and government health programs like Medicare are moving toward so-called value-based payment systems and away from fee-for-service medicine.

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To address the ballooning cost of care, the government has been experimenting with novel payment methods, such as bundled payments or capitation.

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Riskier products could be bundled and sold more efficiently because of new electronic payment systems, and in combinations reaching a greater range of buyers, increasingly far from the original loan.

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When lots of similar receivables are bundled together in an asset-backed security, the average rates of default, late payment and pre-payment are predictable, so both issuers and investors can be relatively confident of their ability to value the security properly.

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