Independence Blue Cross and Rothman Orthopaedic Institute have extended their value-based care agreement for three years. The extension allows the two organizations to continue their work to enhance the quality of care IBX members receive, to address health equity, and to reduce healthcare costs.

“IBX and Rothman Orthopaedics were pioneers in partnering on orthopedic payment models that focus on moving care to the proper setting based on patients’ specific needs,” said Paul Staudenmeier, Senior Vice President of Total Value Contracting and Reimbursement at Independence Blue Cross. “The fact that we have extended our agreement to continue this collaborative work is proof that models like these work and that we’re hoping to do even more to enhance the quality and affordability of orthopedic care in this region.”

Rothman Orthopaedics was the first physician-owned group to work with IBX on an approach that brings health insurers, hospitals, and doctors together to improve the quality and lower the costs of healthcare in the region. The two organizations continue to work together today. They partner on programs that are designed to put Rothman physicians in charge of an entire episode of care — ensuring that appropriate diagnostic tests are completed, that surgery is performed in the most appropriate setting, that post-operative care results in an optimal outcome for IBX members. This type of program helps keep healthcare costs down by eliminating unnecessary services and delays, all while providing members the highest quality care with their doctors highly engaged in the process.

“The data has shown that value-based care works,” said Dr. Alexander R. Vaccaro, President of Rothman Orthopaedic Institute. “Here at Rothman Orthopaedics, we are proud to work with Independence Blue Cross on this model, and we will continue to look for ways to build upon this approach for their members.”

In 2018, IBX and Rothman Orthopaedics expanded their value-based care agreement to include bundled payments for specific procedures they perform on IBX members — not only for hip and knee replacement but including shoulder replacement, knee arthroscopy, lumbar laminectomy, and spinal fusion. This has helped reduce healthcare costs. Since 2018 when the agreement started, Rothman Orthopaedics has lowered the clinically-related costs of these procedures by more than $3,000 per case while reducing hospital admissions by 38 percent and reducing emergency department visits by 29 percent.

Over the next few years, IBX and Rothman Orthopaedics will have the opportunity to continue working on these procedural episodes together. It also opens the door for them to expand their efforts to focus on things such as a new chronic episode of care pilot for low back pain management and initiatives that address health equity in the orthopedic space.

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