Durham, N.C.-based Triangle Orthopaedic Associates created a commercial bundle of orthopedic services, according to Health Leaders Media.
Here are five takeaways:
1. In 2011, the group started discussions with Blue Cross Blue Shield of North Carolina about bundling services, but it took two years to implement the system.
2. Triangle Orthopaedic Associates is comprised of 63 physicians in 23 locations throughout North Carolina.
3. The physician group started total knee replacement bundled payments with BCBSNC in December 2012. The group has since added a total hip replacement and a unicompartmental knee bundle.
4. Triangle's bundled payments are prospective payment models, meaning Triangle has negotiated a flat rate with the BCBSNC for each procedure. Through the bundled payment system, BCBSNC pays Triangle the full amount and the group is responsible for its contracts with the hospital, anesthesia, durable medical equipment and therapy.
5. Patients are matched with a special contact at BCBSNC. A BCBSNC consultant says payer involvement is crucial as patients are more prone to comply with post discharge instructions if they receive consistent messaging from multiple sources.
"We have found that patients who typically take about 24 weeks to reach a desired recovery level after knee replacement are able to achieve those results in 12 weeks," Chief Administrative Officer Chris Adkins said. "A lot of that is from the much more rigorous physical therapy that we can put patients through because, when they don't have the obstacle of copays, they are more likely to continue with outpatient therapy."
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