Louis McIntyre, MD, an orthopedic surgeon, walked through how orthopedic surgeons can implement bundled payment initiatives at the 12th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + The Future of Spine June 13.
"Orthopedics is extremely well-positioned to take advantage of bundled payments," he said, since most procedures are elective and have predictable costs and outcomes with defined start and end times.
To be successful in a bundled payment initiative, Dr. McIntyre mentioned the following necessities.
• Rigorously define the bundle and all services included in it
• Specifically exclude non-covered services
• Access historical cost data to properly set up pricing
• Develop relationships with vendors to get discounted physical therapy for patients or discounted implants — Dr. McIntyre suggested looking at relationships with national healthcare clubs to send patients there for physical therapy, since it saves money on the bundle and health clubs get potential members
• Leverage the site of service price differential that ASCs have
Dr. McIntyre noted that geography and market differences can play a large role in the success or failure of developing a bundled payment initiative, as some payers in certain markets are more open to the idea than others. He gave the example of Blue Cross Blue Shield in the Midwest as being receptive to these types of initiatives.
Bundled payments for orthopedic procedures can be a win-win situation, Dr. McIntyre concluded, as physicians regain economic and clinical control, and the payers win by saving on costs.