New Jersey’s Blue Cross Blue Shield affiliate is taking a cooperative approach to episodes-of-care contracting with orthopedic surgeons and other medical service lines, generating care benefits for patients and sustainable financing for healthcare providers.

With Medicare making many hip and knee replacement procedures subject to mandatory bundled-payment contracting, Horizon Blue Cross Blue Shield of New Jersey has created a bundled-payment offer that is far more attractive to physicians.

“Horizon actively engaged the physicians first—before initiating the program,” says Stephen Zabinski, MD, a practicing surgeon at Shore Orthopaedic University Associates and co-author of a January 2015 bundled-payments report in The Journal of Arthroplasty.

Zabinski’s Somers Point, NJ-based practice is one of five charter members of the bundled-payments program for hip and knee replacements that began at Horizon about five years ago, according to Lili Brillstein, Horizon’s episodes of care program director. “It has changed the nature of the relationship. I’ve heard a lot of doctors say they have a lot of satisfaction with the Horizon program,” she says.”It’s been a positive experience working with them,” he told me.
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