Building Payer-Provider Partnerships for Bundled Payment Models

Health Payer Intelligence April 9, 2020
Emily Sokol, MPH

BCBSRI and University Orthopedics partnered to deliver bundled payment models for hip and knee replacements, highlighting a push towards more value-based reimbursement and holistic care.

A bundled payment model born from a payer-provider partnership between Blue Cross Blue Shield Rhode Island (BCBSRI) and University Orthopedics has helped deliver a holistic, outpatient delivery of a common operation, ultimately highlighting both organizations’ effort to move more towards value-based reimbursement.

The average cost of a total knee replacement is $31,124, according to a study from Blue Cross Blue Shield Association. Total hip replacements are similarly as expensive, averaging $30,124. These totals can feel insurmountable, especially in the healthcare industry increasingly working toward lower costs and better outcomes.

Bundled payments have demonstrated the ability...

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