Here are six takeaways.
1. Horizon BCBSNJ released episode of care results for hip replacement, knee replacement, knee arthroscopy, pregnancy and colonoscopy.
2. The payer reported 100 percent fewer hospital readmissions for knee arthroscopy patients and 22 percent fewer hospital readmissions for knee replacement patients.
3. In 2014, there were 37 percent fewer hospital readmissions for hip replacement patients.
4. The payer also reported a 32 percent reduction in unnecessary C-sections.
5. “The Episode of Care model is a game changer in the progress from fee-for-service to value-based contracting,” said Charles A. Accurso, MD, a Hillsboro gastroenterologist in Horizon BCBSNJ’s Colonoscopy EOC. “By tying financial incentives to quality, it improves the care of the patient while also decreasing costs.”
6. Horizon BCBSNJ paid 51 specialty medical providers approximately $3 million in shared savings through its EOC program. The physicians received the bonuses for achievement in cost savings, patient satisfaction and quality in 2014.
More articles on coding and billing:
The risky business of cutting costs – How this company is lowering costs without raising prices for its employees
Horizon BCBS of New Jersey awards physicians $3M in bonuses – 4 highlights
California legislature to approve tax on healthcare plans – 5 insights
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.