Creating Physician-Owned Bundled Payments

Daniel B. Murrey, MD, MPP

At OrthoCarolina, a multi-site independent orthopedic physician group in the Charlotte area, we lowered cost by 10-30% and dramatically improved outcomes for hip and knee replacement surgery. We did this by creating a standardized coordinated care program and pairing it with commercial bundled payment contracts in which the surgeons took primary financial risk.

KEY TAKEAWAYS

  1. Bundled payments can improve clinical outcomes, reduce variation in care pathways, and substantially lower the cost of joint replacement surgery.

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  2. Consensus-driven pathways, patient and family empowerment, and care navigation are key elements of success.

  3. Private practice physicians can effectively manage performance-based episode-of-care risk.

  4. It is possible to scale such a program and reproduce similar results at multiple sites.

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