Date of Conferral





Health Services


Harold Griffin


AbstractThe goals of the modern health care system are in transition from volume of care to quality of care; as a result, the existing fee-for-service model may be outdated, and value-based systems such as bundled payment models should be evaluated. Accordingly, the purpose of the current study was to explore the perceptions of physicians and nurse practitioners regarding the effects of the Bundled Payments for Care Improvement (BPCI) initiative on the procedures for patient selection, care implementation, and quality measurement. The study was guided by a qualitative approach, a phenomenological design, three research questions, and the Donabedian framework for measuring quality of care. The methodology consisted of face-to-face interviews with a sample of 12 physicians and nurse practitioners. Based on the results of the thematic data analysis, the majority of participants stated that BPCI will have some effect on patient selection. The participants also spoke directly to the changes to care implementation that might results from the transitions to BPCI care. The participants all agreed regarding the importance and implementation of quality measurements, but they expressed differing opinions on the usefulness or quality of such measures. These findings revealed the possibility that patients with complex health issues may be the population that is most significantly affected by the bundled payment system. More flexibility is needed within the bundled payment system to account for the limitless variance possibilities when dealing with the treatment of health issues.