BELOIT Beloit Health System has met the quality standards in regards to knee and hip replacement to qualify for a program that ensures quality service and price considerations for area employees.
Beloit Health System recently met the standards required to participate in the QualityPath program through The Alliance, a cooperative of 240 employers with self-funded health benefit plans.
The Alliance contracts with more than 90 hospitals in Wisconsin, Illinois and eastern Iowa and only five have qualified for the QualityPath program, said Cheryl DeMars, president and CEO of The Alliance. Those health providers that already have been designated QualityPath providers are Gundersen Health System in LaCrosse, Monroe Clinic, Sauk Prairie Healthcare and UnityPoint Health - Meriter in Madison.
This was a high bar, DeMars said of the quality standards for QualityPath. We picked these procedures and worth with clinicians to define the quality markers to meet.
We worked for six months, going through the 21 points set by the QualityPath program, said Tim McKevett, president and CEO of Beloit Health System.
The QualityPath designation at Beloit Memorial Hospital where knee and hip replacement surgeries are performed, goes into effect Jan. 1.
Key elements of QualityPath for surgeries include:
Using national measures of quality to assess hospital-and-doctor pairings.
Requiring participating doctors and hospitals to take steps that lead to better results for patients.
Applying bundled pricing, which means a fixed price is charged for the entire surgical procedure.
Offering a 90-day warranty to protect patients for costly complications or re-operations.
Eliminating out-of-pocket costs or deductibles for patients on a traditional health plan when using QualityPath.
Providing a patient experience manager to offer personal guidance.
McKevett said experts have estimated that by 2018, 70 to 80 percent of reimbursement for healthcare will include bundle payment elements.
The Alliance was out in front of this and we are happy to partner with them, McKevett said.
The Alliance works with several local employers with self-funded health insurance plans including the School District of Beloit, the City of Beloit, Blackhawk Bank, Hufcor and Woodmans.