UPMC Health Plan has designated nine providers as members of its new Center of Excellence for hip and knee replacement surgery.
The included providers have high patient satisfaction, high-quality outcomes and few complications in surgery, the insurer announced. The goal, UPMC said, is to help connect patients with providers that offer the best care.
The Pittsburgh, Pennsylvania-based payer said in the announcement that to choose the Center of Excellence providers it conducted a “rigorous” credentialing process, and the health plan will continue to monitor the hospitals’ performance in patient experience and quality.
Amy Helwig, M.D., chief quality officer for the health plan, told FierceHealthcare that part of what spurred the launch of the center was demand from employers, particularly as orthopedic surgeries are common.
"There is a very large national trend and strong demand from employers, in particular, wanting to see health plans and physicians be involved with centers of excellence around orthopedics," Helwig said.
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Quality and cost of hip and knee replacements can vary significantly, Helwig said, making such procedures a good target for a new center. UPMC Health Plan members who are undergoing a hip or knee replacement are not required to go to a Center of Excellence provider, but it's an informational tool for members so they know which network providers are likely to get them back on their feet the fastest, Helwig said.
UPMC isn't tying payments to the status in the center, Helwig said.
The providers tapped for the Center of Excellence are:
- Armstrong County Memorial Hospital
- Butler Memorial Hospital
- Heritage Valley Beaver
- Monongahela Valley Hospital
- UPMC East
- UPMC Magee Hospital
- UPMC St. Margaret
- UPMC Passavant
- UPMC Shadyside
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UPMC Health Plan said that it will accept additional applications for the Center of Excellence and expects to designate additional providers in the near future. Helwig said there isn't a cap on participation, and the insurer is working to process applications from more providers at present.
She said the health plan would be glad to include all of its in-network providers in the center if they reach the required level of performance.
Operating such a center, she added, would be far harder if UPMC wasn't an integrated system, which makes it easier for the plan to work closely with clinical teams to launch initiatives like this.
“This program is built on the foundation of knowledge and experience of our great surgeons and clinical and operational leaders across UPMC,” said MaCalus V. Hogan, M.D., vice chair of orthopedic surgery at the health system, in a statement.