The Minimus Distinction

Bundled Payments play an acute role in reigning in runaway spending. They unleash open market forces on healthcare; triggering competition and transparency; enabling patients to truly understand the cost of their care. The case study below details this point.

Case Study: 2015-2016

Between 2015 and 2016, Monterey Peninsula Surgery Centers performed 159 surgical cases for a California-based Self-Insured Employer. Average savings: $14,370 per case.
Total cost savings: $2.28 Million

Bundled Payment Savings for a Large California-based Self-Insured Group

Case Description Bundled Fee Allowable Hospital Allowable (1) Difference Case Volume 2015 Case Volume 2016 Savings delivered to
Self-Insured Employer
Total hip replacement $28,500 $77,221 $48,721 4 5 $438,489
Total knee replacement $27,000 $75,640 $48,640 4 4 $389,120
Major shoulder reconstruction $12,980 $24,390 $11,410 17 11 $319,480
Major Spine (Fusion) $27,000 $81,000 $54,000 2 4 $324,000
Major Spine (Non-fusion) $14,500 $40,060 $25,560 2 9 $281,200
Knee, elbow arthroscopic repair $8,250 $14,750 $6,500 13 15 $182,000
Hysterectomy/Bladder sling/ Oophorectomy $12,578 $39,640 $27,062 3 10 $351,806
Lithotripsy $10,363 $18,160 $7,797 6 3 $70,173
Laproscopic cholesystectomy $11,062 $55,400 $44,338 1 3 $177,352
ACL repair $13,850 $26,850 $13,000 2 8 $130,000
Endoscopic sinus repair $11,000 $19,310 $8,310 3 2 $41,550
Mastectomy/breast reconstruction $17,750 $39,890 $22,140 1 1 $44,280
Hernia/vascular repair $7,534 $14,230 $6,696 3 4 $46,872
Bunionectomy/bone spur removal $9,250 $16,820 $7,570 2 1 $22,710
Endoscopic carpal tunnel repair $10,990 $16,580 $5,590 2 0 $11,180
Achilles tendon repair $10,850 $21,040 $10,190 1 0 $10,190
Tonsillectomy/adenoidectomy $7,500 N/A N/A 5 2 N/A
Miscellaneous N/A N/A N/A 5 1 N/A
Total 76 83

1Includes regional hospital facility allowable fee, surgeon, first assistant and anesthesiologist allowable professional fees.

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