Build a Bundled Rate

Building a bundled rate for reimbursement. As you can imagine one of the biggest challenges, ten years ago, in building the recovery suites model was finding a way to pay for it. At that time the outpatient joint replacement did not have an outpatient code that we could submit to the commercial payers for reimbursement.

I began to develop a relationship with the payers and a reimbursement model called ‘the bundle rate’. And in the bundle rate we included the surgery center, the outpatient recovery suites, the center, the surgeon, the anesthesiologist, and even the implant company. And building that bundled rate was simply leveraging rates that already existed in your local community and these procedures are already being performed in hospitals and they’re putting in top rec implants you’ve got surgeon and anesthesiologists just like we do.

So when investigating those rates we felt we would discount the bundled rate that was already present in the community. As a result of that bundled rate we would be able to do hips and knees in our surgery center and have done so for ten years. After 2,500 patients that bundled rate has changed and improved based on clinical outcomes, quality, lower readmission rates and certainly almost eliminating infections and complications.

So the bundled rate is very important. Let us help you negotiate it, let us help you build it, and let’s enjoy it together.