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April 2017
Introducing Blue Cross and BCN hip and knee replacement bundled payment arrangement
Please submit your completed RFA document and a signed copy of the program addendum to Blue Cross and BCN by 5 p.m. Tuesday, April 18, 2017.
Health care reform is driving significant change in health care, with cost becoming paramount to consumers. In addition to a reasonable price, consumers want access to quality, local health care providers and services.
In response, Blue Cross Blue Shield of Michigan and Blue Care Network released a Request for Application for a two-year hip and knee bundled payment arrangement to begin in January 2018. The arrangement will entail a single price for all services related to hip or knee replacement — from surgery through recovery. You and providers across the state are eligible to submit a response to the RFA, expressing interest in the program.
The goal of this arrangement is to:
- Reduce variability in cost and quality among hip and knee replacement procedures across the state.
- Improve care coordination and patient outcomes.
- Encourage the shift toward outpatient hip and knee replacement, when clinically appropriate.
The bundled payment arrangement will be one of many benefit options available to Blue Cross and BCN commercial members seeking high value care for their hip and knee replacement procedures. It doesn’t constitute an exclusive or narrow network.
There are quality standards providers must meet to participate in this arrangement. Providers who don’t meet the criteria will remain eligible to receive payment for these services according to their traditional fee-for-service contracts with Blue Cross and BCN.
If you’re interested in participating, you must submit your completed RFA document and a signed copy of the program addendum to Blue Cross and BCN by 5 p.m. Tuesday, April 18, 2017.
For more information about the program or a paper copy of the RFA and contract, please send an email request to HipKneeRFA@bcbsm.com.
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