Two major Michigan health insurers are rolling out bundled payments for hip and knee replacements, Crain's Detroit Business reports.
Here are four things to know.
1. Blue Cross Blue Shield of Michigan signed up two orthopedic medical groups, five hospitals and 65 orthopedic surgeons into a bundled payment program for non-complicated hip and knee surgeries in patients under 65 years old. Southeast Michigan providers will be paid a single fee for the 90-day episode of care, including physical therapy, rehabilitation, home health or nursing home care.
2. On Jan. 1, Priority Health began its 90-day bundled knee and hip package, with 33 surgeons and Royal Oak, Mich.-based Beaumont Health and Holland (Mich.) Hospital under contract.
3. Priority Health CMO James Forshee, MD, said Priority will add back and spine surgery to the bundled payment program.
4. According to Troy, Mich.-based physician management organization Triarq Health, more than 45,000 hip and knee replacements are performed annually in Michigan, ranging from $28,000 to $55,000. Along with spinal fusion, percutaneous coronary angioplasty and caesarean section, they are one of the five most expensive surgical procedures.
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