The Use of Ancillary Services under a Bundled Care Versus a Fee-For-Service Payment Model

Lauren Caldwell, Gabriela E. Halder, Stephanie Nutt, Rebecca G. Rogers, Michelle L. Wright, Audrey Baum, Amanda B. White

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objectives Colocated services in a team-based integrated practice unit (IPU) optimize care of pelvic floor disorders. Our goal was to compare ancillary service utilization in a multidisciplinary IPU between patients covered by a bundled payment model (BPM) versus a traditional fee-for-service model (FFSM). Methods Medical records of women attending an IPU for pelvic floor disorders with colocated services, including nutrition, social work, psychiatry, physical therapy, and subspecialty care between October 2017 and December 2018, were included in this retrospective chart review. All patients were offered treatment with ancillary services according to standardized care pathways. Data extracted included patient demographics, pelvic floor disorder diagnoses, baseline severity measures, payment model, and ancillary services used. Univariate and multivariate logistic regression identified variables predicting higher uptake of ancillary services. Results A total of 575 women with pelvic floor disorders presented for care during the study period, of which 35.14% attended at least 1 appointment with any ancillary services provider. Ancillary service utilization did not differ between patients in the BPM group and those in the FFSM group (36.22 vs 33.47%; P = 0.489). Social work services were more likely to be used by the BPM compared with the FFSM group (15.95 vs 6.28%; P < 0.001). The diagnosis of fecal incontinence was associated with a higher chance of using any ancillary service (odds ratio, 4.91; 95% confidence interval, 1.81-13.33; P = 0.002). Conclusions One third of patients with pelvic floor disorders receiving care in an IPU used colocated ancillary services. Utilization does not differ between payment models.

Original languageEnglish (US)
Pages (from-to)493-496
Number of pages4
JournalFemale Pelvic Medicine and Reconstructive Surgery
Issue number8
StatePublished - 2021
Externally publishedYes


  • ancillary services
  • bundled payment model
  • pelvic floor physical therapy
  • value-based care

ASJC Scopus subject areas

  • Surgery
  • Obstetrics and Gynecology
  • Urology


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