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ASC-specific bundled payments program coming to California — 8 key concepts

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Bundled payments may be coming to more ambulatory surgery centers in California — are you ready?

Blue Shield of California partnered with Global One Ventures to launch the Bundled Fee Program for ASCs. "The single payment option motivates facility and physicians to function as one team and to adopt best practices," said Global One Ventures Principal Tom Wilson. "This program was developed out of a need for transparency in pricing for routine surgeries performed at an ASC."

Here are eight things to know about the program:

1. The program is designed for facility, surgeon and anesthesiologist alignment to promote higher quality care in the low cost setting.

2. Orthopedic and joint replacement surgeries are ideal for the program because they are pre-diagnosed conditions.

3. The payers will include a single payment to reduce waste and redundancies while aligning providers around a surgical episode of care.

4. The program is expected to become the main surgical episode payment methodology for PPO members over the next five to 10 years.

5. There would be one price and bill to the patient, and costs would be transparent as well as lower than other options.

6. Surgeons are able to perform higher acuity cases in the ASC with the bundled rate, which can lower infection and complication risks.

7. Global One will handle any program appeals that BSC requires.

8. The billing is streamlined.

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