Under UHC’s Spine and Joint Solution bundled payment program, patients covered by UHC undergoing these types of procedures can make an upfront payment – covered by UnitedHealthcare – and get coverage for the procedure as well as pre- and post-surgical care.
At the beginning of 2018, HMH’s chief innovation officer, Dr. Andrew Pecora, oversaw the creation of a prospective, upfront payment model for breast cancer patients at HMH’s John Theurer Cancer Center in partnership with Horizon Blue Cross Blue Shield of New Jersey.
At the time, Pecora said that breast cancer treatment at JTCC had become predictable enough that HMH was able to come up with a value-based model that allows patients to make an upfront payment to pay for surgery and pre- and follow-up care for one year. HMH did not specify whether the bundled payment option for joint and spinal procedures would also cover treatment for up to one year.
“This program is one example of the ways we are reshaping how health care is delivered, helping enhance care coordination, improve outcomes and deliver greater value,” said Dr. Sam Ho, chief medical officer at UnitedHealthcare. “The initial results and nationwide expansion demonstrate the value of this program to health care providers, employers and their employees, helping to improve health outcomes and make care more affordable for more people.”