DURHAM, N.C. -- Duke University Health System and Blue Cross and Blue Shield of North Carolina (BCBSNC) are partnering in an effort to save money and improve the quality of knee replacement surgeries performed by Duke's nationally ranked orthopedic service. By seeking innovations in care coordination and delivery, Duke’s care teams will optimize joint replacement services while taking an important step in lowering the cost of care.
The project is designed to replace the individual costs of each of the many services provided for a successful knee replacement with a single flat-fee intended to cover everything associated with this episode of care. Duke and its care teams will continue to achieve the high quality measures that have made them a perennial top 10 orthopedic service by U.S. News & World Report, while also delivering the complete knee replacement surgery care within the flat-fee reimbursement.
“These kinds of efforts in new care models that help drive greater efficiencies while increasing quality will become more and more prevalent and clearly represent the future of health care delivery,” said Victor J. Dzau, M.D., Chancellor for Health Affairs at Duke University and CEO of Duke University Health System. “Duke is committed to being a leader in exploring new treatment models that achieve the triple aim of better access, higher quality and lower costs.”
This “bundled payment” project will cover the entire knee replacement care spectrum, including the pre-surgical period of 30 days prior to hospitalization, the surgery itself, and most follow-up care within 90 days after discharge from the hospital. This program was effective on Jan. 1, 2013, and will be available to BCBSNC members when knee replacement procedures are performed by Duke University physicians at Duke University Hospital or Durham Regional Hospital.
“Partnerships like this one are possible when hospitals, physicians and insurers commit to new ways of putting patients first by collaborating to improve quality and reduce costs,” said Lisa Cade, BCBSNC Vice President of Network Management.
“This project is a great example of collaboration between providers and a payer to advance care, but it also provides more tangible ways to engage patients directly in optimally contributing to their successful outcomes,” said David Attarian, M.D., medical director of musculoskeletal services and vice chair for orthopedic clinical operations at Duke.
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Note: The bundled payment arrangement does not apply to BCBSNC customers under FEP and Blue Medicare plans.
About Blue Cross and Blue Shield of North Carolina:
Blue Cross and Blue Shield of North Carolina is a leader in delivering innovative health care products, services and information to more than 3.6 million members, including approximately 900,000 served on behalf of other Blue Plans. For 78 years, the company has served its customers by offering health insurance at a competitive price and has served the people of North Carolina through support of community organizations, programs and events that promote good health. Blue Cross and Blue Shield of North Carolina was named one of the World’s Most Ethical Companies by Ethisphere Institute in 2012. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Visit BCBSNC online at bcbsnc.com.
About Duke University Health System:
Duke University Health System is a world-class health care network dedicated to providing outstanding patient care, educating tomorrow's health care leaders, and discovering new and better ways to treat disease through biomedical research. With more than 15,000 full-time employees, the health system encompasses three highly regarded hospitals, including the flagship Duke University Hospital, ranked among the top 10 in the United States.