Blue Shield of California has developed an innovative joint-replacement program, developed with help from the the Society for Patient Centered Orthopedics and the California Orthopedic Association. Cambridge Management Gr0up has been intensely involved in bundled-payment programs for joint replacements.
This HealthAffairs piece reports that the new California program “requires objective assessment of the indication for surgery, including the use of patient-centered assessment tools and documentation of a completed CollaboRATE shared decision making survey by the patient as a component of the pre-authorization process. Blue Shield will also collect a nine-item Shared Decision Making questionnaire (SDM-Q-9) directly from patients and will provide prospective surgical candidates with decision aids. Finally, the success of the joint replacement from the patient’s perspective will be measured by obtaining pre- and post-operative PROMIS (Patient Reported Outcomes Measurement Information System) scores directly from surgical patients.”