Aetna is implementing an automated bundled payment model at a southern California orthopedic center. The insurer hopes the move will encourage evidence-based care while reducing complications and duplicated services.
Instead of separately paying each doctor for each medical service provided, Aetna will create a set, comprehensive fee for various episodes of care for the Hoag Orthopedic Institute doctors, the company announced Tuesday.
"Bundled payments, particularly when automated, can increase operational efficiencies to provide additional value to both our members and our plan sponsor customers," said Elizabeth Curran, head of Aetna's National Network Strategy and Program Development.
This is the first use of the automated bundled payment created by the Integrated Healthcare Association (IHA), which claims the automation could potentially save $300 billion in health expenditures in the next eight years, according to the Hartford Business Journal.
Information technology consultant McKesson also is collaborating with Aetna and Hoag Orthopedic on the project. Aetna members with commercial health plans who meet certain criteria are eligible for the new payment approach, Insurance & Technology reported.