Over the past seven days, two major orthopedic groups with ASCs on opposite coasts signed partnerships with insurance companies to expand bundled payments.
On May 18, Philadelphia-based Rothman Institute and Independence Blue Cross went public with news of their partnership, a five-year deal bundling the cost of surgery and postoperative care. On May 22, Newport Beach, Calif.-based DISC Sports & Spine Center reported partnering with Global One and Blue Shield to form an in-network bundled payment model.
Here are five things to know.
1. Rothman Institute is the first large, independent physician group to affiliate with Independence Blue Cross' health networks model. The practice includes several office locations and more than two dozen outpatient surgery centers across Pennsylvania and New Jersey, as well as Rothman Orthopaedic Specialty Hospital in Bensalem, Pa.
2. The agreement between Rothman and Independence Blue Cross is effective July 1 and will expand the procedure selection Rothman offers under bundled contracts. Physicians will now perform hip, knee and shoulder replacements as well as knee arthroscopy, lumbar laminectomy and spinal fusion for Independence Blue Cross members at bundled rates.
3. Rothman is in charge of the entire episode of care, and Independence Blue Cross may enter into similar arrangements with other groups if all goes well. The partners plan to share data to provide better care and understand spending to keep costs low.
4. DISC Sports & Spine's partnership with Global One and Blue Shield will give bundled rates to the payer's in-network subscribers for minimally invasive spine surgery, orthopedic surgery, sports medicine and pain management services at DISC's surgery centers.
5. The partnership between DISC and Blue Shield is effective immediately and includes surgical services as well as postoperative care. The partners say bundled rates will promote price transparency, as the single cost for a surgical episode will eliminate surprise bills.