One Bill Knee Surgery Gaining Adherents

The one-payment movement for knee surgery is gaining momentum. Blue Cross and Blue Shield of North Carolina announce a deal with Duke University Health System that allows the insurer’s customers to make one payment for the procedure. The payment will cover care for a pre-surgical period of 30 days before the hospitalization, the surgery and follow-up care for 90 days after the patient is discharged from the hospital.

Neither the press release nor the report in the January 17 Durham Herald Sun disclosed the insurers’ or hospitals’ charge.

The program became effective at the first of the year and is available to Blue Cross’s customers when knee replacements are done by Duke University doctors at Duke University Hospital or at the Durham Regional Hospital.

“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, ” Victor J. Dzau, M.D., chancellor for health affairs at Duke University, and CEO of Duke University Health System, was quoted as saying in the release.

Blue Cross and Blue Shield of North Carolina has made a similar one-payment arrangement with Triangle Orthopaedic Associates when knee replacement surgery is performed at the specialty hospital jointly owned by Triangle Orthopaedic Associates.

As is done at Duke, the bundled payment includes pre-operative tests and office visits within 30 days of the procedure, appointments and care during the hospital stay, and related outpatient care for 90 days after surgery.