Embracing a rising trend among payers, UnitedHealthcare has launched a bundled payment option for patients in its employer-sponsored plans who undergo knee, hip and spine procedures.
The insurer announced Thursday that the Spine and Joint Solution will be available to large and midsize employers across the country that offer United plans. The program connects participating patients who are enrolled in employer-sponsored plans with providers that accept bundled case rates for knee and hip replacement, spinal fusion and spinal disc repair. The providers, currently located in 25 different markets, must also perform a high number of such procedures and demonstrate superior outcomes.
The Spine and Joint Solution kicked off as a pilot program last year, and participating employers have saved an average of $10,000 per operation compared to median costs in their region, according to the announcement. Employees eligible to participate in the program have saved money, too, to the tune of more than $1,000 in out-of-pocket costs at participating providers. Research has shown that costs for knee and hip replacements, in particular, can vary widely between providers.
“Knee, hip and spine surgeries are among the fastest increasing categories of medical procedures, so this program provides a new way to help improve the quality of care, produce better outcomes for patients and better manage costs for employers,” Sam Ho, M.D., chief medical officer of UnitedHealthcare, said in the announcement.
United isn’t the first payer to launch a new payment option for orthopedic surgeries. The Centers for Medicare & Medicaid Services announced last year that it would create the Comprehensive Care for Joint Replacement model, which targets fee-for-service Medicare beneficiaries. Humana also released a list of best practices for bundled payment models earlier this year after announcing that it would offer bundled payment options to its Medicare Advantage members seeking hip or knee replacement surgery.