17-Point Framework · Updated 2026
Bundled Payment Vendor Evaluation Checklist
Benchmarked against criteria used by CFOs and bundled payment coordinators who have evaluated DataGen, NaviMedix, Archway Health, and Cedar Gate.
Completed: 0 / 17 items
Analytics & Data
Core capability
Real-time episode cost dashboard — Can care coordinators see live cost tracking, or does data arrive only at reconciliation? Critical
Claims data refresh frequency — Ask for the claims lag time. Anything longer than 2 weeks is operationally too slow for active episode management.
Post-acute utilization analytics — Can you compare your SNF and home health partners by readmission rate, LOS, and cost per day side by side? Critical
Surgeon-level episode scorecards — Can you generate individual physician-level episode cost vs. peer benchmarks? Physician engagement without data doesn't work.
CMS Compliance & Reconciliation
Financial risk
Preliminary target price modeling — Does the vendor model your target prices before the CMS reconciliation period so you can forecast financial performance quarterly?
Reconciliation support & dispute process — Who owns reconciliation review? Do they provide a dedicated advisor or just a ticketing system? Critical
CMS quality measure integration — Does the platform track your BPCI-A quality measures and alert you to performance gaps before reconciliation adjustments hit?
Multi-payer episode management — Can you manage both CMS and commercial bundled payment contracts in the same platform? Separate systems create blind spots. Important
Care Coordination Workflow
Clinical impact
High-cost episode alerts — Are care coordinators automatically notified when an episode tracks above target before discharge, not after? Critical
Patient navigation support — Does the platform include post-discharge patient outreach workflows or does your team build this manually?
EHR integration depth — Ask specifically: is this a flat data extract or bidirectional integration? Can care managers update patient records from within the platform?
Vendor Qualifications
Due diligence
References from similar hospital type — Ask for 2 references from hospitals within 20% of your bed count and surgical volume. Generic references don't count. Critical
Documented savings performance — Ask for audited or verifiable episode savings data from current clients, not marketing claims. Critical
Implementation timeline & go-live SLA — What's the contractual go-live date? Who owns delays? What's the penalty if they miss it?
Data ownership & exit rights — Who owns your episode data if you leave the contract? Can you export it in a usable format? Important
Pricing model transparency — Is pricing PMPE, flat license, or gain-share? Get all-in Year 1 and Year 3 cost projections in writing before any demo commitment.