UnitedHealthcare has inaugurated a new value-based care payment for knee, hip and spine procedures that concentrates on quality patient care and better outcomes. The initiative – the Spine and Joint Solution – is present to employers nationwide and works with health care facilities that conduct a higher number of these surgeries and have demonstrated better results and fewer complications.
The Spine and Joint Solution provides UnitedHealthcare employer-sponsored plan participants access to surgeons and facilities that qualify as UnitedHealthcare Centers of Excellence and accept bundled case rates for certain procedures, involving knee and hip replacement, spinal fusion and spinal disc repair. The program presently involves more than 40 health care facilities in 25 markets across the country, with plans to expand to more than 40 markets during the year of 2017.
The bundled payment method reimburses a care provider or hospital for a defined episode of care, like knee or hip replacement, under a single fee or payment. This is a shift away from the usual fee-for-service structure in which a care provider is paid for each treatment, appointment or test, generating multiple claims within a single, broader episode of care.
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