Revolutionizing Healthcare: Unlocking the Power of Bundled Payment Systems for a Sustainable Future

Table of Contents Chapter 1 Introduction ······································································································· 3
1. Research Background ············································································································ 3
A. A reasonable payment system that responds to changes in population and disease ··························································· 3
B. The impact and role of the payment system on the health care system ······························· 4
D. Attempts and expansion of alternative payment systems for payment system diversification ·································· 6
B. Bundled Payment System ······························································································· 7
2. Research Purpose ………………………………………………………………………………………………………………………… 7
3. Research Contents ········································································································ 8
4. Research Methods ········································································································ 8

Chapter 2 Current Status and Limitations of Domestic Payment Systems ……………………………………………………………………………………………. 11
1. Domestic payment system performance and limitations ················································································ 11
A. Fee-for-service system ······································································································· 11
B. Comprehensive fee system for 7 disease groups ··············································································· 12
D. New Comprehensive Payment System ········································································································· 13
Ra. Deduction and Payment Business ………………………………………………………………………………………………………….. 15
2. Sintering ·································································································· 16

Chapter 3 Overseas Alternative Payment Systems ……………………………………………………………………………………………. 19
1. US Bundled Payment System ……………………………………………………………………………………………. 19
A. Introduction Background and Development History ············································································ 20
B. CMS Bundled Payment Business ···························································································· 24
D. CMS Bundled Payment System Performance ·································································· 43
Ra. Expected effects and issues of bundled payment system ······················································································ 45
Ma. Sintering ······································································································ 51
2. Dutch Bundled Payment System ………………………………………………………………………………………………………….. 52
A. Background ………………………………………………………………………………………………………………………… 52
B. Bundling system in the Netherlands ………………………………………………………………………………………………………….. 54
3. The UK integrated health care system and bundled payment system ························································· 56
A. Background ………………………………………………………………………………………………………….. 56
B. Operating System and Features ……………………………………………………………………………………………. 56
All. Evaluation ······································································································ 58
B. Related Bundled Payment System ……………………………………………………………………………………………. 59
Ma. Sintering ······································································································ 60

Chapter 4 Cases of Overseas Payment System Reform ·································································································· 65
1. United States ………………………………………………………………………………………………………….. 65
A. Legislation and Dedicated Organization (CMS Innovation Center) ··········································· 65
B. Participation of the medical community ······················································································ 82
All. Sintering ······································································································ 86
2. Taiwan ································································································· 87
A. Overview ··································································································· 87
B. Reorganization process ································································································ 88
D. Organization and Laws ········································································································ 91
La. Sintering ······································································································ 95

Chapter 5 Designing, Evaluating, and Implementing Alternative Payment Systems ………………………………………………………………… 99
1. Development of alternative payment systems ……………………………………………………………………………………………. 99
A. Design steps for a successful alternative payment system ················································ 99
B. Alternative Payment System Components ……………………………………………………………….. 102
D. Implementation and Evaluation of Alternative Payment Systems ·································································· 122
2. Physician-focused alternative payment models ································································ 126
A. Alternative payment models designed by the medical community ……………………………………………………………….. 126

Chapter 6 Payment System to Support Sustainable Healthcare System ············································································ 139
1. Exploring the possibility of applying the bundled payment system domestically ················································································ 139
A. Necessity of applying bundled payment system ························································································· 139
B. Applicable clinical episodes ·········································································· 140
Ease of application ·························································································· 141
2. Key Measures for Applying the Domestic Bundled Payment System ················································ 141
A. Directionality ………………………………………………………………………………………………………….. 141
B. Payment method and applicable target ························································································· 142
D. Application of the bundled payment system (advance presentation of target price, post-adjustment mechanism) ······················· 144
3. Considerations and Strategies for Implementing the Bundled Payment System ········································· 147
A. Considerations for Implementation ······························································································ 147
B. Strategy for Implementation ……………………………………………………………………………………………. 149

Chapter 7 Conclusion ………………………………………………………………………………………………………….. 153
1. Conclusion ················································································································ 153
2. Importance of the study and follow-up research ……………………………………………………………………………………………. 156
A. Importance of the study ………………………………………………………………………………………………………….. 156
B. Follow-up research ······························································································· 156

◾ References ······················································································· 157
◾ Appendix ···························································································· 163
◾ ABSTRACT ················································································ 198