IBX and Rothman Orthopaedic Institute have extended their contract by three years
Rothman was the first physician-owned group to sign a contract with Independence Blue Cross that provided one payment for all the services that go into a procedure, such as a joint replacement.
Independence Blue Cross and Rothman Orthopaedic Institute have extended a contract that has helped trim 11%, or $3,000, from the average cost of Rothman orthopedic surgeries between 2019 and 2022, the two health-care organizations said Wednesday.
“IBX and Rothman Orthopaedics were pioneers in partnering on orthopedic payment models that focus on moving care to the proper setting based on patients’ specific needs,” Paul Staudenmeier, senior vice president of total value contracting and reimbursement at IBX, said in a news release.
That approach resulted in a massive shift of orthopedic surgeries from hospitals to outpatient settings. In the first half of 2022, 73% of Rothman’s hip and knee replacements were performed as outpatient procedures, compared with just 14% on outpatients who did not stay in the hospital in the first half of 2019, The Inquirer has reported.
Contributing to that savings was a 38% reduction in hospital admissions and a 29% reduction in emergency department visits by Rothman patients, IBX said.
“The data has shown that value-based care works,” Rothman president and spine surgeon Alexander Vaccaro said.
In a 2018 contract, Rothman expanded bundled payments — which cover all costs of an episode of medical care — beyond hip and knee replacement to include shoulder replacement, knee arthroscopy, lumbar laminectomy, and spinal fusion.
IBX has similar agreements with Premier Orthopedics, Cardiology Consultants of Philadelphia, and Regional Women’s Health Group.