Rothman, Cigna sign value-based contract for Florida market

Laura Dyrda -   Print  |

Philadelphia-based Rothman Orthopaedic Institute has contracted with Cigna for in-network value-based care for the practice's offices in Florida.

The practice had a longstanding relationship with Cigna prior to this new deal, which gives Cigna members in-network care at Rothman facilities effective June 1. The practice is a pioneer in value-based contracting, and President Alexander Vaccaro, MD, PhD, said he sees the trend evolving from bundled payments to a more sophisticated model of care.

"In the next two to three years, value-based care will change due to the rise of popular bundle payment scenarios and the beginning of population health management paradigms," he told Becker's. "Bundle payments today should be reflective of diagnosis-related groups, which can vary drastically."

He said the diagnostic-related groups for cervical and lumbar spine surgery cases can range from $11,000 to more than $100,000 for the same diagnosis, but the variation isn't taken into account for current CMS bundled payments.

"Value-based care must better align with specific CPT coding, as there is great variation in surgical procedures, especially in deformity surgery, where number of levels or complexity is not factored into bundle reimbursement," he said.

Rothman partnered with AdventHealth to expand into Florida last year, and the new partnership will bring thousands of Cigna members into its network.

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