Excelsior Orthopaedics and Buffalo Surgery
Center.
Some say such a disparity in charges is a
testament to the economy and efficiency of
outpatient surgery, and an indictment against
the exorbitant cost of elective surgical care in
hospitals.
"It's interesting that the bundled payments
we've negotiated with payers have put pres-
sure on the rest of the providers in the com-
munity to lower their episode-of-care cost for
joint replacements," says Mr. Uba. "The pay-
ers are using our program as a model to
approach hospitals and physician groups to
say, "Look, these guys can do procedures at
this cost. Why can't you?'"
Besides enhancing reimbursement for sur-
geons (see "Unraveling the Bundled
Payment" on page 21), bundled payments
shift control back to where many think it
belongs: with physicians.
"The true value of the bundled payment
model is that it gives you more control over
the flow of dollars and the flexibility to redis-
tribute where those dollars are going," says
Mr. Uba. "For too long, the person providing
the care had no control over outcomes, quali-
ty and costs."
Bundles also incentivize physician-owners
to get much more engaged in implant negotia-
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