sider how their technique is impacting the overall cost and standard-
ize to make care more consistent."
If you're thinking of participating in a bundled payment program for
total joints, keep in mind that these programs require your facility to
take on more responsibility of the total care of the patient during and
after the procedure — beginning with admission and ending 90 days
after discharge. But some say the rewards of better quality, tighter
care coordination and lower costs might make it worthwhile.
A standard joint replacement bundle is around $30,000 for a 90-day
episode, with average savings ranging from $1,000 to $5,000, says
Amol Navathe, MD, PhD, an assistant professor at the University of
Pennsylvania in Philadelphia, Pa.
"There's a lot of variation across total joint cases that can be
smoothed out and waste that can be cut out, and those savings can
then be split among the other stakeholders," says Dr. Navathe.
"Bundling payments for a total episode of care for total joint cases is
becoming more popular, since it's ideal for creating alignment with
insurance providers, the physician, nurses and physical therapists."
There's also a "day-of-surgery" only model that covers the surgery
center, the surgeon and the anesthesiologist for about $20,000, says
Stephen Lucey, MD, an orthopedic surgeon at the Surgical Center of
Greensboro (N.C.). Dr. Lucy and a group of orthopods formed Delta
Joint Management Group to help organize and implement a bundled
payment program at their surgical center.
"With our model the surgeon runs the business and takes the risk so
he may receive more reward than just his surgical fee if results are
excellent and the business does well," says Dr. Lucy.
How it works
The most well-known bundled payment models come through
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