Following in the footsteps of Twin City Orthopedics of Minneapolis, Minnesota, Florida Blue and the Mayo Clinic announced collaboration aimed at providing a knee replacement at one cost. Like many surgeries, a knee replacement involves numerous individual medical procedures and processes. When done separately, the cost of care adds up quickly. Florida Blue and Mayo officials say that, with this agreement, the bundled services are provided at one cost that will eventually provide stakeholder savings.
Mayo Goes for One Charge TKA
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According to the Agency for Healthcare Research and Quality, health care professionals perform more than 600, 000 knee replacements annually in the United States. TKA’s (total knee arthroplasty) are the most common joint replacement procedure.
The primary procedures that will be included in the bundled, one-charge package, according to Mayo Clinic officials, include all related surgical procedures as part of the knee replacement, anesthesia services, injections or drugs administered during the surgical procedure, (including antibiotics), radiology/imaging services, cost of the implant and surgical supplies, discharge planning and nursing care and office visits.
“We are honored to collaborate with Mayo Clinic to create a unique bundled care model for our members considering knee replacement surgery, ” said Andy Marino, vice president of network development for Florida Blue. “This is another great example of a continued shift to new care models that focus on delivering the highest quality of care while reducing the cost burden for stakeholders.”
Dr. Mary O’Connor, Chair of Orthopedic Surgery at Mayo Clinic in Florida, said that “Mayo Clinic is committed to working with partners in the community so that more individuals can benefit from our safe and technologically advanced surgical care. Our model of integrated medical care has been repeatedly shown to deliver high quality at lower cost which is important for both our patients and insurance partners.”
The bundled payment agreement took effect December 15, 2012, and applies to all Florida Blue commercial plans, excluding Go Blue and Cover Florida plans.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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