September 15, 2021
Two of the biggest names in health care in the region have been piloting a new payment program they say has saved area employees more than $1 million in its initial year. The effort is now being expanded more broadly across other specialties and health systems.
Beacon Orthopaedics & Sports Medicine, one of the region’s largest independent physician groups, and Anthem Blue Cross and Blue Shield in Ohio, one of the state’s largest health care insurers, said a new bundled payment agreement is providing cost savings to employers and patients while also improving outcomes for workers.
The agreement provides opportunities to perform more orthopedic procedures at Beacon’s outpatient ambulatory surgery centers rather than inpatient hospital settings. Beacon said the move offers care at a lower cost — surgery in an ambulatory setting versus inpatient costs roughly 45% less, Beacon says — with better outcomes and more convenience for patients.
Bundled payments are similar to a prix fixe for health care versus ordering a la carte. Anthem said it encourages better coordination of care by replacing a piecemeal approach with a comprehensive one. Since launching the agreement July 1, 2020, Beacon and Anthem said they have saved area employers more than $1 million.
Beacon CEO Andy Blankemeyer told me the program has centered around total joint replacement and spine surgery, two very high-dollar procedures.
The physician group is now looking to expand it to other orthopedic procedures.
“This is an innovative collaboration between a health plan and a physician group that is driving cost savings and quality,” Blankemeyer said. “By shifting more services to an outpatient setting, the savings can be significant.”