UnitedHealthcare saved employers $18 million with knee, hip and spine bundled payments; now they're ready to expand.
Here are four things to know.
1. The program, called The Spine and Joint Solution, successfully reduced hospital readmissions by 22 percent and joint replacement complications by 17 percent when compared with non-participating facilities. While employers saved around $18 million, individuals also saved about $3,000 in out-of-pocket costs per procedure when using a bundled-participating facility instead of another in-network medical facility.
2. Individuals are incentivized to undergo knee, hip and spine procedures with cash, gift cards, additional vacation days for recovery and health savings account contributions. The program reimburses healthcare providers and facilities for the defined episode of care under a single payment.
3. UnitedHealthcare is expanding the program to 46 participating facilities, up from 40 two years ago, and has 115 employers enrolled, covering 3 million employees. The program is open to any size of company with self-funded health plans and accepts the bundled rates for knee and hip replacements, spinal fusion and spinal disc repair at one of the UnitedHealthcare Centers of Excellence.
4. Over the past three years, UnitedHealthcare's provider reimbursements tied to value-based care have tripled to $64 billion and the company expects to reach $75 billion by the end of 2020. There are currently around 15 million UnitedHealthcare benefit plan enrollees with access to the payer's value-based care programs.