OBJECTIVES: This paper presents a proposal to introduce a program aimed at measuring health and patient-related outcomes and implementing bundled payment for healthcare facilities to cover the complete cycle of care for patients with osteoarthritis (OA) of the hip and knee. The objective is to integrate the treatment process, incentivize improved outcomes, and lower complications and associated costs.

METHODS: The International Consortium for Health Outcome Measurement (ICHOM) standardized set was selected to measure outcomes and compare clinical care for patients with hip and knee OA. Patients eligible for bundled payment include those with OA requiring surgical treatment and categorized as ASA I and ASA II according to the American Society of Anesthesiologists classification. The program is designed as a one-year pilot project in Bulgaria, with voluntary participation from healthcare facilities.

RESULTS: The program aims to achieve high value by focusing on health outcomes achieved per unit of monetary value spent. By implementing bundled payments and measuring outcomes, the program seeks to improve quality of care, promote learning and improvement, reduce costs, and facilitate the adoption of best practices. It also allows patients to choose the most suitable facility while promoting the identification and dissemination of best practices.

CONCLUSIONS: By implementing a value-based payment model and measuring outcomes, the proposed program has the potential to improve the quality of care for patients with OA. The pilot project will evaluate the program's effectiveness based on feedback from participating healthcare facilities and an analysis of its impact on clinical outcomes. The expected outcomes include improved patient health, reduced complication rates and associated costs, and increased value for patients, healthcare facilities, regulators, and the overall health system.