Blue Cross Blue Shield of Michigan launched a bundled payment pilot program in the state for total joint replacements.
Here are four things to know.
1. BCBSM launched the program with 64 surgeons at seven Michigan-based health systems. The health systems involved include:
• Henry Ford Health System
• Huron Valley Sinai Hospital
• Michigan Orthopaedic Surgeons
• Oakland Regional Hospital
• St. Joseph Mercy, Brighton
• St. Joseph Mercy, Livingston
• TRIARQ Health
2. Per the episode of care, Blue Cross aims to save around 10 percent off the current average cost of non-complicated knee and joint replacements. The pricing was developed based on historical costs by geographies; currently the episode of care can cost anywhere from $28,000 to $55,000.
"The variation in cost across hospitals and geographies is significant," said Steve Anderson, vice president of provider contracting and network administration at Blue Cross. "For example, many patients may be more comfortable and rehabilitate better at home, versus a rehab facility."
3. This is the first Blue Cross bundled payment program and includes fully insured employers with the Blue Cross PPO and Blue Care Network HMO. The bundle will cover the 90-day episode of care, including physical therapy.
4. The program will cover nine counties in Michigan; overall, BCBSM covers 4.6 million Michigan residents and employees of Michigan-based companies.