standpoint, bundled arrangements
offer potentially drastic benefits to
our healthcare system, as they're
proven to be more cost-effective.
Historically, Medicare reim-
bursement rates have been incre-
mentally higher in hospital-based
settings than ambulatory settings,
with facility fees, anesthesia fees,
etc., billed at a higher rate. I think
that landscape is going to change
because the government realizes
things can be done more inexpen-
sively away from hospitals. As we
gather data, CMS expects a push
to safely move more cases to
ASCs. They're starting to realize
there's greater interest in terms
of which Medicare patients can
eventually be pushed into ambu-
latory settings. From a joint
replacement or arthroplasty
standpoint, this model has
enabled us to create a bundled
payment program that works
extremely well, because our
physicians and administrators are
allowed the creativity to con-
struct initiatives that control
costs. In turn, that allows us to
have some say in terms of how
we construct contracts with ven-
dors, and how we agree upon
standardized methods of care
that help lower costs. It can be a
real gain for the system.
• Price transparency. With
our total joints bundle, which we
dubbed EXCEL Orthopedic
Surgery and Recovery Program,
our patients know right off the
bat what the cost of their total
shoulder surgery will be: $24,500.
That price covers everything —
total care, from day one till you're
fully recovered, including your
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*World Journal of Anesthesiology m2014 March 27; 311); n9-123; ISSN 221806182 lonline);
Baishideng Publishing Group Co. Note: Pumps were set to a nominal fl ow rate of 12 ml/hr.
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