Industry Insights

Value-based payment – A place where healthcare needs to go to keep premiums (costs) down

Now that we are entering the home stretch of the year, many health plans are turning their attention to reimbursement innovation, where many, if not most roads lead to value-based contracting. A recent McKinsey article indicated that premium reductions of 18% have been achieved using value networks, compared to standard, broad-based network products. McKinsey says that “…a provider’s level of ‘skin in the game’ is among the most important predictors of the impact of value-based payment.

Study: Commercial Insurance Cost Savings in Ambulatory Surgery Centers

Author: Healthcare Bluebook and HealthSmart via Advancing Surgical Care

A review of commercial medical-claims data found that U.S. healthcare costs are reduced by more than $38 billion per year due to the availability of ambulatory surgery centers (ASCs) as an appropriate setting for outpatient procedures. More than $5 billion of the cost reduction accrues to the patient through lower deductible and coinsurance payments.

Pacira CEO David Stack says 70% of surgeries will be outpatient in 10 years — Here are the key drivers

Author: Laura Dyrda, Becker’s

Mr. Stack said he sees the move to outpatient surgery as an important driver for the company’s success in the future. The company estimates around 70 percent of surgeries are done in hospitals and 30 percent are done in ASCs; however, over the next 10 years Mr. Stack projects that will flip to 70 percent of surgeries performed in an outpatient or ambulatory setting and 30 percent in the inpatient hospital.

Total hip & knee replacements in the US by age group: 8 statistics on incidence

Here are eight statistics on the rate of total hip and knee replacements in the United States, according to the CDC’s National Hospital Discharge Survey: 2010.

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When patients have to pay the difference, they choose less expensive ASC’s for care

The more financial responsibility patients share with their insurers, and the more they understand the disparity in prices charged by freestanding ambulatory surgery centers

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Inside Our Outpatient Total Joints Program

We’ve developed a comprehensive approach to outpatient hip and knee replacements, so we know a thing or two about what it takes to launch a successful program.

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CMS will cancel major bundled payment initiatives

CMS has proposed canceling the cardiac and expanded joint replacement bundled payment models.

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Price of a common surgery varies from $39,000 to $237,000 in L.A.

A short drive in the Los Angeles area can yield big differences in price for knee or hip replacement surgery.

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