OrthoCarolina announced Tuesday it has partnered with three other large orthopedics groups to form a national organization to establish quality standards and contract directly with employers to provide orthopedic and spine care at transparent prices.
The new group, called the National Orthopaedic & Spine Alliance, includes the Cleveland Clinic, the CORE Institute based in Phoenix, and Rothman Institute based in Philadelphia.
Two other groups, OrthoIndy in Indianapolis and Hoag Orthopedic Institute based in Irvine, Calif., have signed letters of intent to join the alliance later.
“This is really a physician-led enterprise to create a national consensus on the best way for orthopedic and spine care to be delivered,” said Dr. Daniel Murrey, CEO of OrthoCarolina, one of the largest orthopedic practices in the Southeast.
Murrey, who heads the alliance’s quality committee, said the group is “developing quality standards and care pathways that we’re going to each agree upon.” Doctors in the alliance will be able to show employers – and their employees – historical results for patients who’ve had various procedures.
And they’ll “be upfront about the cost.”
Finding the cost of a procedure today can be difficult to impossible. Surgeons charge one price, anesthesiologists another, and hospitals another.
The New York Times recently told the story of a man who got a hip replacement for $13,660 in Belgium, including the implant, the surgeon’s fee, a hospital room for five days, a week in rehabilitation and a round-trip ticket from America. When he had tried to price the procedure in the United States, he was told he could get the implant for $13,000, but the hospital would add another $65,000, not counting the surgeon’s fee, the Times reported.
“We understand patients’ frustration,” Murrey said. “They feel like they’re a number and not a person. ...We should be able to tell them what they’re going to experience and what their outcomes are going to be and what it’s going to cost.”
The alliance will contract directly with large employers to provide orthopedic and spine care at specified prices, called “bundled payments,” that will cover a patient’s entire experience.
“Employers have been telling us they’re paying more and more for health care, and they don’t really see what they’re getting for it,” Murrey said. “We’re trying to be responsive to that. They’ll know the quality and know exactly what they’re going to pay for it, upfront.”
The alliance has not yet signed any contracts with employers, Murrey said, but it plans to have enrolled patients by early next year.
In Charlotte, Murrey said, surgeries under alliance contracts probably will be performed at hospitals in the Novant Health system, which already has an agreement with the Cleveland Clinic’s cardiac program. But Murrey said OrthoCarolina doesn’t yet have a contract with Novant and will be interested in working with Charlotte’s other hospitals, in Carolinas HealthCare System, at some point.
“We plan to work in both systems ultimately to provide bundled services,” Murrey said.
“We really feel like we’re trying to deliver on the promise that physicians have made: We’re going to manage your care at a reasonable cost with a predictable outcome while providing a great experience for the patients and their family.”
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