Workers with health insurance coverage through several large employers including Walmart and Lowes now have the option of getting a joint replacement free of charge. Through the Employers Centers of Excellence Network established by the Pacific Business Group on Health (PBGH), four providers—Johns Hopkins Bayview Medical Center (Baltimore), Virginia Mason (Seattle), Kaiser Permanente Orange County (Irvine, CA), and Mercy Hospital (Springfield, MO)—negotiated bundled-payment agreements based on their high volumes, better-than-average outcomes, and lower-than-average complication rates. Instead of paying the usual deductibles and copays, patients travel to one of these four providers and don’t pay a penny for the procedure or travel expenses. The non-profit PBGH has 60 large-company members that provide health care coverage to 10 million people, including active employees, retirees, and dependents.
Keeping you up-to-date with orthopaedic news
I think this is a nice option for employees.They are getting quality care with no out of pocket expense. However, I will refuse to see any of these patients for any complication related to their surgery in my practice or in the hospital. Hopefully, they have a system for transporting patients with complications back to the center of excellence.
What if it’s Friday night, you’re on call for the entire weekend and they show up 2 wks postop with a draining wound, febrile and ill-appearing, in your ER. It’s a 4-6 hour drive to the center of excellence. You can’t send them back. You’ll have to wash them out at least, maybe do something more. Not an ideal system at all.
You can send them back
Iv antibiotics to hold them over and a phone call to alert them here they come, although not what I would do
Why so much resistance to change? The majority of the septic joints I care for were done by someone outside my community. I perform 300 joints a year and care for 6-8 infections a year, almost all from another primary surgeon. If you don’t want the business, ship them back. I seldom turn away the business. .