Walmart's centers of excellence program cut joint replacement costs by 15% — 5 things to know

Written by Angie Stewart | March 18, 2019 | Print  |

Walmart's centers of excellence program, which pays for employees to travel and receive care at designated facilities, was expanded in 2014 to include hip and knee replacements.

In 2018, Walmart implemented a 50 percent copay for employees who received joint replacements outside the COE network. The change caused COE utilization to spike 113 percent, although charges were waived for emergent and urgent conditions.

Harvard Business Review examined the program's success.

Five things to know:

1. From 2015 to 2018, 1,836 Walmart associates had joint replacement surgery at a COE site, constituting 18 percent of all employees who underwent the procedure in that timeframe. About two-thirds of those patients were women, and most were 50 to 64 years old. COE specialists determined 20 percent of patients wouldn't benefit from surgery.

2. Because COE patients had better outcomes and avoided unnecessary procedures, Walmart's cost per case was about 15 percent lower at COE sites than at non-COE hospitals. The cost for joint replacements at COEs was $23,505, compared with $27,721 at non-COEs.

3. Patients spent about 1.7 days in COE hospitals, 32 percent less time than patients who went to hospitals outside the program. COE patients returned to work after 11.3 weeks, a week and a half sooner than non-COE patients.

4. COE joint replacement patients had fewer postsurgical complications and were 70 percent less likely than non-COE patients to be readmitted to a hospital. None of the COE patients required care in a skilled nursing facility after discharge, compared with more than 5 percent of patients who received care outside the network.

5. The article's authors include Lisa Woods, head of Walmart's U.S. benefits design and strategy; neurosurgeon Jonathan R. Slotkin, MD, who serves as spine surgery director at Danville, Pa.-based Geisinger Neuroscience Institute and associate chief medical informatics officer at Geisinger Health in Danville; and Health Design Plus founder Ruth Coleman.

More articles on orthopedics:
Enhanced recovery after surgery pathway leads to rapid discharge & high patient satisfaction – 3 study findings
Posterior hip replacement patients may not need precautions, Hospital for Special Surgery study finds — 4 notes
Dr. Robert Bell expands hand & upper extremity care to outreach clinic: 3 notes

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