Choosing high-quality, lower-cost procedures can pay off—in cash.
There is often a huge variation between what hospitals charge for joint surgeries.1,2 That’s why Blue Cross NC launched a clear and simple approach.
Joint replacement surgeries are some of the most common surgeries in the nation and demand is growing.3,4 Consequently, they make up a large portion of health care costs.5 Yet costs and results can vary significantly from facility to facility.
That’s why Blue Cross NC was one of the first insurers to launch bundled payments for knee and hip replacements back in 2013. These value-based arrangements help to simplify and improve our customer’s experience. Today we are expanding our groundbreaking program by adding even more participating providers and procedures. And, it’s all a part of Blue Cross NC’s commitment to transform health care in our state by paying for the value of health care, not just paying for every test, visit and procedure as we have in the past.
What are bundled payments?
Bundled payments are an agreement between insurers and health care providers in which providers receive a flat fee for an entire course of care for knee and hip replacements—from surgery consults to post-surgery follow-up and physical therapy. This agreement encourages doctors, physical therapists and other team members to provide more coordinated, effective and efficient care. And, customers know what they can expect to pay from start to finish.
Better health, lower costs, streamlined billing
Blue Cross NC has eight bundled payment arrangements with four high-quality health care systems. Results are promising, including:
Bundled payments are just one example of our value-based arrangements that help improve care, lower costs and make for a better patient experience. These type of arrangements are the exception today, but they are expected to be the standard in the future. We’re excited about the possibilities they hold for everyone involved.