Value-based care and bundled payments have been gaining momentum in the ASC industry as a means to reduce healthcare costs and improve patient care.
Here are nine insights and updates on value-based care and ASCs:
1. Optum, which includes ASC chain Surgical Care Affiliates, sees huge potential in value-based care this year. More than 500,000 new patients will be covered by OptumHealth's value-based arrangements this year.
2. Leawood, Kan.-based ValueHealth is an ASC company with more than 3,000 affiliated physicians that focuses on value-based surgical offerings. The company recently embarked on a joint venture with Penn State Health, a new part-owner in the Surgery Center of Lancaster (Pa.). In August, the company launched an outpatient bariatric and metabolic hyperspecialty offering, dubbed ValueHealth NovaCore, that uses a value-based, scalable model to offer bariatric and metabolic surgery in multispecialty centers.
3. In June, Surgical Center of Greensboro (Tenn.) released outcomes of its first 1,000 commercial prospective 90-day bundles, which created $15 million in savings for payers, a new revenue stream for ASCs and extra income to surgeons based on a quality metric system.
Several payers have also seen opportunities in value-based care and expanded bundled payments this year:
1. Sharonville, Ohio-based Beacon Orthopaedics & Sports Medicine and Anthem Blue Cross and Blue Shield in Ohio piloted a bundled payment agreement that has saved employers more than $1 million in its first year.
2. Seattle-based Regence BlueShield added more providers and covered more procedures in its bundled payment program, which decreased the cost of orthopedic procedures by 16 percent since its January 2020 launch.
3. Blue Cross and Blue Shield of North Carolina's Blue Premier value-based program performed almost 10,000 more colorectal screenings in 2020 than in 2019, the company said Aug. 25.
4. In early August, Blue Cross Blue Shield of Michigan added to its portfolio an unnamed physician management services business to deliver business support to independent physicians transitioning to value-based care models.
5. In August, Regence BlueCross BlueShield of Oregon added Rebound Orthopedics & Neurosurgery, a 36-physician practice, to its Episodes of Care program, which offers bundles for various procedures such as lumbar spinal fusion, shoulder replacement and hip and knee replacement and revision.
6. Seattle-based Regence BlueShield expanded its Episodes of Care value-based care program to include gastroenterology services. Episodes of Care is Regence's first value-based arrangement to cover clinical procedures, beginning with orthopedics. It now includes gastroenterology, cardiac procedures and maternity care.