tions — that adds value
and a renewed ability
to manage your rev-
enues and costs.
Following these 5 steps
will help you build your
bundled payment pro-
gram.
1
Know the costs
You can't price
your bundle without
first knowing exactly
what you spend on
every element of the total episode of care, which can be divided into 3
parts:
• Base facility cost. Include the expense of having patients com-
plete their histories and physicals and undergo pre-op lab tests (if
both will be in your bundle). Add in the costs of all medical and surgi-
cal supplies (including implants and consumables), nursing staff,
pharmaceuticals, durable medical equipment, pre- and post-op X-rays
and scans, and physical therapy — all the elements needed to prepare
patients for surgery, perform the procedure and help them recover.
• Surgeon's fee. The surgeon's fee is based on reasonable fair market
value for their cost of delivering their services — their time and resource
utilization necessary to perform total joint procedures. First, calculate
how many hours they spend with a typical patient from the initial clinic
visit through to the 3-month post-op visit. Multiply the number of hours
by their average practice cost per hour.
• Anesthesia fee. Complete the same exercise for your anesthesia
7 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J A N U A R Y 2 0 1 9
• DRILLING DOWN Determine the exact expense of delivering on every element of
the episode of care to identify cost-saving possibilities.
