Blue Cross, University Orthopedics partner on joint replacement bundled payment plan

UNIVERSITY ORTHOPEDICS is hoping to move some of its joint replacement surgeries out of a hospital setting into its new Kettle Point Ambulatory Care Center as a result of a collaboration with Blue Cross & Blue Shield of Rhode Island. / COURTESY JH COMMUNICATIONS

EAST PROVIDENCE – University Orthopedics Inc. and Blue Cross & Blue Shield of Rhode Island have agreed on a new payment model for outpatient joint replacement surgeries.

The bundled payment plan, available only to Blue Cross commercial members, is designed to shift some joint replacements from an inpatient or hospital setting to University Orthopedics’ Kettle Point Ambulatory Care Center in East Providence.

The plan mirrors a bundled option made available earlier this year for Blue Cross commercial members who undergo joint replacements at the Kettle Point center.

The newly announced bundle includes the cost of surgery, postoperative exams, physical and occupational therapy provided in the recovery center, as well as several other services.

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Outpatient hip, knee and shoulder replacement or arthroplasty surgeries are covered under the agreement.

The plan makes the most of the Kettle Point center, according to Dr. Edward Akelman, president of University Orthopedics.

“This partnership with BCBSRI allows our patients optimal access to a multitude of services while also focusing on convenience,” he said.

The bundled plan marks the first such payment model that Blue Cross has developed for joint replacement surgeries performed outside of a hospital.

“This innovative partnership reinforces our commitment to ensuring our members receive best-in-class care while still reducing health care costs,” said Kevin Splaine, executive vice president of care integration and management at Blue Cross. “We believe this agreement, and the shift from charging fees for every individual service to a bundled payment model, is an important step in our efforts to make health care more affordable for Rhode Islanders.”

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