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Sarah Neville

2022–23 Australian Harkness Fellow; Director of Analytics at the Independent Health and Aged Care Pricing Authority

Headshot of Sarah Neville

Placement: University of Pennsylvania

Mentors: Amol Navathe, M.D., Ph.D., Assistant Professor, Medical Ethics and Health Policy; Co-Director, Healthcare Transformation Institute; Associate Director, Center for Health Incentives and Behavioral Economics, Perelman School of Medicine, University of Pennsylvania

Ezekiel Emanuel, M.D., Ph.D., Vice Provost for Global Initiatives, Diane v.S. Levy and Robert M. Levy University Professor, Codirector of the Healthcare Transformation Institute, University of Pennsylvania

Project: Bundled Payments — What Makes Them Work?

Sarah Neville, Ph.D., is a 2022–23 Australian Harkness Fellow in Heath Care Policy and Practice. She is currently the director of analytics at the Independent Health and Aged Care Pricing Authority. Neville has worked in the Australian health system for ten years, setting the price of hospital services in order to make hospital funding more transparent and equitable. She joined the Independent Health and Aged Care Pricing Authority in 2013 and has since held successive roles as director of pricing, executive director of data and analytics, and senior advisor of statistics and research. Neville is passionate about the power of statistics to inform evidence-based policy, both in Australia and internationally. Her interests lie in health funding systems, particularly innovative funding models, as well as women in STEM leadership. She is the current chair of the School of Mathematics and Applied Statistics Advisory Committee at the University of Wollongong, where she completed a Ph.D. in mathematical statistics.

Project Overview: Value-based health care has been lauded as the new paradigm to curb health spending and improve quality of care worldwide. Many forms of value-based payment models exist, with one of the most promising being bundled payments, where payments are made to health providers for a clinically defined episode, or bundle, of related health care services. Under a bundled payment model, the provider assumes the risk — they are required to cover costs that exceed the price for the bundle of services, but they also share in any savings when the cost of care is below the price. This risk is a key component in the design of bundled payments, and it must be accounted for in order to incentivize equitable care. Quality must also be monitored in conjunction with bundled payment models to ensure cost effectiveness does not reduce quality of care.

The aim of this research is to gain firsthand knowledge of the design, implementation, monitoring, and evaluation of bundled payment models in the U.S. in order to understand the factors that determine the success of these models. The research will have a particular focus on how risk is managed in the design of bundled payment models, and whether vulnerable populations have equitable coverage and outcomes under the models.