BCBSNC Kicks Off Orthopedic Bundles

Jacqueline Fellows, for HealthLeaders Media , February 19, 2013

Blue Cross Blue Shield of North Carolina has just started testing out its bundled payment model for knee replacement surgeries, and if performs well, the model could be pushed out to include hip replacements.

Elaine Daniels, the plan's senior strategic network consultant, says BCBSNC started modeling orthopedic bundles in 2010, began a pilot project in 2011, and recently announced two bundled payment initiatives with physician-owned Triangle Orthopaedic Associates (TOA) and Duke University Health System.

"When you're looking at doing bundles on a first pass, orthopedic procedures were easier for us because there aren't that many complications," says Daniels. "There's not a lot of leakage, you know who the care team is going to be, so there's more continuity of care for that member or patient."

Both bundled payment arrangements were announced within the last two months and apply to BCBSNC members who have knee surgeries performed at North Carolina Specialty Hospital, a facility jointly-owned by TOA, as well two Duke-affiliated hospitals, Duke University and Durham Regional.

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