California Hospitals, Physicians to Begin Bundled Fees for Hip, Knee Replacements

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Several California hospitals will begin using bundled fees, which include both facility and physician fees, when billing for hip and knee replacements, according to a report by the Los Angeles Times.

Hospitals participating in the pilot program, which is being overseen by the non-profit Integrated Healthcare Association, include Cedars-Sinai Medical Center and UCLA hospitals, both based in Los Angeles, and Hoag Memorial Hospital Presbyterian in Newport Beach.

The program mirrors Medicare's bundled payment pilot programs, but will involve commercial insurers and just two procedures. Aetna, Blue Shield of California, CIGNA and HealthNet have agreed to participate, according to the report.

While the specific charges have not yet been set, the bundled fee is expected to cover nearly all aspects of medical treatment related to the procedures, such as physician fees, implant costs, imaging services and other tests, for up to 90 days after the surgery, according to the report.

The pilot program is intended to help hospitals better coordinate care and will begin in August.

Read the Los Angeles Times' report on the California bundled fee pilot program.




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