ASC Total Joint Bundled Payment Program Achieving Triple Aim

St. Cloud Surgical Center has long been an innovator. Its total joint replacement program, developed with SCA, has led to higher quality, lower costs and a streamlined approach to healthcare: a bundled payment that simplifies the process of surgery and recovery.

  • 96% go home same day
  • 0% infection rate
  • 30% lower cost than hospital
“We’re leading the effort to keep costs down. The bundled payment sends a strong message to the payer: quality is very high, costs stay low and patients love it because the process is easy and seamless. They get one bill and we manage the care from surgery to physical therapy.”

Jeanette Stack, Administrator, St. Cloud Surgical Center

St. Cloud Surgical Center (SCSC), 90 minutes northwest of Minneapolis, is a pioneer in outpatient surgery. The center, which has 48 physician partners, opened in 1972 and was the second freestanding ASC in the country. Today, in partnership with Surgical Care Affiliates (SCA), SCSC continues to innovate.

In 2015 SCSC started conducting outpatient total knee and total hip replacements using robotics. Since starting the program, more than 200 procedures have taken place without a single fall, hospital transfer or infection.

SCA developed a bundled payment with Blue Cross and Blue Shield of Minnesota to create a seamless continuum of care, from surgery to physical therapy—and all with just one bill.  The single payment covers the surgeon’s fee, anesthesia and facility charges, post-surgical physical therapy, home health care, etc. “It’s one payment for the procedure and all the services a patient might need related to the surgery within 90 days,” says Marie Edler, MPH, Vice President, Payer Engagement and Advocacy at SCA.

According to Jeanette Stack, Administrator for the center, SCA manages the entire process, paying the anesthesiologist, physician and physical therapist, while ensuring that quality remains high. “We’re leading the effort to keep costs down. The bundled payment sends a strong message to the payer: quality is very high, costs stay low and patients love it because the process is easy and seamless,” says Stack.

Says Dr. Nessler: “The program is an excellent way to offer my patients and the insurers a cost effective solution to total joint replacement that appropriately shifts the financial incentives to us as care givers to make the optimal clinical decisions for our patients.”


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