title: Perspectives on Advancing Bundled Payment in Ontario's Home Care System and Beyond.
abstract: Now more than ever, healthcare funders are weighing options to drive better value in care delivery, including using bundled payments to compensate healthcare providers based on expected costs to achieve specific health outcomes for patients. Ontario is currently exploring options for expanding bundled payment beyond acute care to home care, primary care, long-term care and across the continuum of care. This paper reviews the evidence, including the Ontario experience with bundled payment, and identifies opportunities for advancing bundled payment in home care as well as with other sectors. The authors consider the most promising opportunities, offer perspectives on where to start and identify the critical success factors. They conclude that is unlikely that payment reform on its own would be sufficient to drive changes in care delivery across providers. Instead, the evidence from the review points to the need to shift the conversation on bundled payment to a larger strategy for integration of care across providers and to engage providers in designing solutions, particularly for supporting chronic and complex patients who require support from multiple providers across the system.
authors.affiliation: Chief performance officer and senior director, Performance Improvement and Outcomes at the Toronto Central CCAC and is Chair of the CCAC Provincial Working Group on Performance Management and Reporting.
authors.forename: Anne
authors.initials: A
authors.lastname: Wojtak
authors.affiliation: Senior director, Client Services at the Toronto Central CCAC and was recently Co-Chair for the Short Stay Post-Medical Home and Community Care Patient Functionality Committee for Health Quality Ontario.
authors.forename: Dipti
authors.initials: D
authors.lastname: Purbhoo
mesh_terms: D017048:Health Care Costs; D006699:Home Care Services / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D009864:Ontario; D012051:Reimbursement Mechanisms / Q000458:organization & administration*