Payers and providers are redefining and rethinking how new models of care can move the needle toward value-based care. Learn about recent examples.

1. Bundled Payment Pilot for Knee and Hip Replacements

BlueCross BlueShield of Michigan has recently launched a pilot program that will use bundled payments for knee and hip replacements in order to manage costs and improve member outcomes. Designed to cover both the surgery and 90-days of post-surgery care, the bundles are estimated to save 10 percent of the average cost of such care episodes.

BCBS data suggests that knee and hip replacements typically cost anywhere between $28k-$55k—representing a significant variation across hospitals and geographies. The test program is a relatively good size, covering surgeries in nine Michigan counties and accounting for nearly a third of hip and knee procedures performed. All in all, a total of sixty-four surgeons across seven different health systems will receive bundled payments as reimbursements for these episodes of care.


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