Global Bundling

Global bundling involves a single pre-set payment to a provider or group of providers for a wide range of services delivered to an individual over a period of time, usually one year.19 As distinct from episode-based bundling, which involves a payment for a single episode of care, global bundling is often used for patients with conditions that involve a higher likelihood of hospitalizations and potential for readmissions.20 Global payment amounts are risk-adjusted based on the patient’s health and other characteristics that may affect the services needed, such as age or gender, in a manner similar to the risk adjustment of capitation rates.capitation rates. In addition, global payment may be structured to incorporate outcome or quality measures, to safeguard against under-service, and to reward high performance. Other terms used to describe the concept of global bundling include: risk-adjusted global fees, comprehensive care payment, and global payments. Relevant Federal Legislation or Regulation: Medicaid Global Payment System Demonstration Project, ACA § 2705. Authorizes demonstrations, in up to five states for FY2010-FY2012, to shift safety net hospitals from Medicaid FFS payments to a global capitated payment model. This demonstration is not currently funded.