Bundled Payment FAQs
The Bundled Payments for Care Improvement Initiative (BPCI) allows Panama City Surgical Center physicians to collaborate and improve the efficiency and quality of individual episodes of care. Multiple costs are bundled into one in order to increase the potential to reduce Medicare, Medicaid, or Children’s Health Insurance Program (CHIP) expenditures while preserving or enhancing quality of care. Bundling multiple costs allows us to lower our surgical cost so that we can provide better-coordinated care and offer you an opportunity to make better healthcare purchasing decisions.
Q. What is a surgical bundled payment?
A. This means that our surgeons “share” one fee – a single comprehensive payment – for a surgical procedure or treatment covering all costs for a particular medical condition. Patients with no insurance or big deductibles embrace this national trend. In short, it improves health, creates a better patient experience, and lowers the cost of the delivery of the service.
Q. What does a bundled payment include?
A. A bundled payment is an episodic-based or packaged price. By posting our bundled service fees, it allows you to know the price of the surgical procedure, anesthesia services, facility services, (1) pre-operative visit, and (1) non-complicated post-operative follow-up.
The prices for the procedures listed on this website include the facility fee, the surgeon’s fee and the anesthesiologist’s fee. The initial consultation with the surgeon is also included, as is uncomplicated follow-up care. The duration of postoperative care is different for each surgical procedure. Therefore, your surgeon will inform you at the initial consultation the amount of postoperative care covered by the price. The $200 initial consultation fee is applied to the total cost of the procedure should surgery be indicated. If surgery is not indicated the $200 will be retained by us. Our goal is for the price to be as transparent as possible.
Q. What does a bundle payment NOT included?
A. Any diagnostic studies necessary prior to the surgery such as lab, MRI, X-rays, consultations with specialists to determine medical risk/management, physical therapy and rehabilitation.
Any hardware or implants necessary for completion of the procedure (plates and screws, e.g. for orthopedic procedures). This price information will be provided prior to surgery but subsequent to the surgical consultation. Our experienced surgical staff knows with almost certainty what will be needed to complete your surgery and this hardware or implants will be provided to you at invoice cost without any markup whatsoever. Copies of the invoices will be provided to you.
Expenses or fees resulting from complications subsequent to the completion of the surgery and discharge from the facility are also not included.
Q. What do you need to know about bundled costs?
A. By providing one set rate we require one payment of which is known before service is rendered. This creates more transparency and allows patients the details and final cost of the service provided in order to plan accordingly.
Q. Who are bundled payments more likely to benefit?
A. Private pay patients and self-insured employers may benefit greatly from knowing surgical and related costs ahead of time. This helps everyone – patients, insurers, physicians – to be able to plan a better budget for operational efficiency.
Q. Why define the cost of a surgical procedure?
A. It’s easier for our physicians to develop a single cost for a procedure because it creates a more responsible business model within which to work singularly and as a group at one site. Plus, insurance companies are leaning toward this model in the future. In short, bundled payments become more efficient, simple, transparent, and can predict costs for regular operations. By creating efficiency, procedures become more effective through volume.
Q. Is it a lower cost for me to go to a surgeon who has a bundled and posted a cost for my procedure?
A. Our patients like knowing exactly what the cost will be. Some prefer to “shop” for a procedure. However, our quality physicians are usually chosen over others to deliver their care because of the collective value we put on the patient-physician relationship. We feel this is extremely important and reflects our reputation.
Q. What is a surgical center’s purpose in posting the costs for a particular procedure?
A. Our physicians understand that an inferior surgical outcome may require additional care – and that care may not be reimbursable. Bundled payments drive our physicians toward maintaining and exceeding quality care. It allows us to achieve the highest value of services for the lowest possible cost by standardizing procedures, utilizing group purchasing to ensure lower operational costs, and creating more volume, which in turn lowers cost. Through this volume, we are able to find cost efficiencies and increase revenue so we can provide advanced technologies, such as new devices or implants.