BCBSNC Kicks Off Orthopedic Bundles

The reason BCBSNC decided to partner with Duke and TOA on its bundled is because it had a good working relationship with both organizations. She says getting senior management on board early on in the process helped the negotiations along, as well as in-depth study of who was likely to work best as a partner.

"We did an analysis to see 'Where's the biggest bang for our buck?' We wanted to choose partners that were doing a fair number of these procedures to begin with, and folks that we had a really good, strong working relationship, and then also those that kind of think outside the box," says Daniels.

Daniels cites TOA's place of setting and care innovations as "ahead of the curve," and Duke University is one of only seven sites in North Carolina participating in the federal government's massive bundled payment care initiative (BPCI) announced by the Centers for Medicare & Medicaid Services recently. Duke will participate as a Model 2 site, which will look at the retrospective care for an acute hospital stay plus post-acute care for percutaneous coronary interventions.

"We're still in the early stages," says Daniels. "We're going through a learning curve. We are wide open to looking at new ideas."