ONE-BILL JOINT SURGERY GROWING (Orthopedics This Week)
Is the practice of charging one inclusive payment for surgical services, sometimes called “bundled payments,” the future of joint replacement surgery? Executives at Blue Cross Blue Shield of North Carolina (BCBSNC) and the surgeons at Triangle Orthopaedic Associates (TOA) believe that it is.
Instead of billing separately for the surgeon, hospital, physical therapist, anesthesiologist and others, the two organizations, since 2012, have cooperated to provide for one-bill replacement surgery for knees. And on November 1, 2013, they began offering the same flat fee bundled terms for hip replacements. The surgeries are performed at North Carolina Specialty Hospital in Durham.
BCBSNC spokespersons Elaine Daniels and Lew Borman told OTW that insurers are moving away from the traditional fee for service reimbursement model to one that involves paying for a service. Both said they saw this system as the wave of the future in funding joint replacement. Daniels said that when they began paying a flat fee for knee replacements, they “expected to see positive results with this. Instead”, she said, “the results have been transformative.”
Amo...
