Anthem Blue Cross and Blue Shield in Missouri and SSM Health Care-St. Louis Collaborate on Payment Innovation

ST. LOUIS, March 9, 2011 /PRNewswire/ -- In a move designed to help control health care costs while still maintaining a high quality of care, Anthem Blue Cross and Blue Shield in Missouri has collaborated with SSM Health Care-St. Louis to develop an alternative to fee-for-service reimbursement for total knee replacements through a bundled-payment initiative.

"Anthem is pleased to work with SSM Health Care-St. Louis on this important and innovative initiative. This marks a vital step in enhancing the value we deliver to our shared customers," said Ruth Meyer Hollenback, Anthem vice president, Provider Engagement and Contracting.

The bundled payment offered through this collaboration includes all services associated with knee replacement, both professional services such as physical therapy and follow-up visits, as well as facility services.  

"Across the entire health care spectrum, from employers, consumers, health care providers and health plans to state and federal government, there is a common goal to lower the cost of health care while maintaining the quality of patient care," said Wayne Meyer, M.D., medical director of Anthem Blue Cross and Blue Shield in Missouri. "In this collaborative spirit, Anthem and SSM Health Care-St. Louis joined together to create a payment initiative toward this goal."

SSM Health Care-St. Louis owns and operates the SSM Joint Replacement Center at DePaul Health Center in Bridgeton, Mo., a division of SSM Orthopedics. A bundled payment strategy for total knee replacements allows for the SSM Joint Replacement Center to be reimbursed a flat rate that encompasses all appropriate components of care, such as the hospital stay, physical therapy, durable medical equipment, readmissions for revisions or complications, and outpatient post-operative care. This payment strategy allows hospitals to manage the cost of services while maintaining quality care for patients.

"At the SSM Joint Replacement Center we take great pride in the medical care we provide and are thrilled to be recognized by one of the leading health insurance companies as an excellent place to receive care," said Drew Rector, service line executive for SSM Orthopedics.

The SSM Joint Replacement Center ranks in the top five percent in the nation for patient satisfaction. At the center, surgeons perform more than 1,000 knee replacements annually --  the highest number of any hospital within the metropolitan St. Louis area. In 2009, the SSM Joint Replacement Center earned the Gold Seal of Approval™ for health care quality. The SSM Joint Replacement Center at DePaul Health Center is currently the only Missouri hospital to be awarded the Joint Commission's Disease-Specific Care Certification for knee and hip replacement. It has also been designated by the Blue Cross and Blue Shield Association as a Blue Distinction Center for Knee and Hip Replacement.

Anthem Blue Cross and Blue Shield in Missouri

In Missouri (excluding 30 counties in the Kansas City area): Anthem Blue Cross and Blue Shield is the trade name for RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Also, follow us on Twitter at www.twitter.com/healthjoinin, on Facebook at www.facebook.com/HealthJoinIn, or visit our YouTube channel at www.youtube.com/healthjoinin.

About SSM Orthopedics

SSM Orthopedics comprehensive program offers prevention, diagnosis, treatment and rehabilitation of a full spectrum of musculoskeletal disorders and injuries. We offer five locations in St. Louis and St. Charles counties including: SSM St. Clare Health Center, Fenton; SSM DePaul Health Center, Bridgeton; SSM St. Mary's Health Center, Richmond Heights; SSM St. Joseph Health Center, St. Charles; SSM St. Joseph Hospital West, Lake Saint Louis. Our team of board-certified physicians, specially trained nurses and therapists deliver exceptional care to our patients. The SSM Joint Replacement Center at DePaul Health Center is a division of SSM Orthopedics. For more information, visit ssmhealth.com/orthopedics.

About SSM Health Care-St. Louis

Our mission statement – "Through our exceptional health care services, we reveal the healing presence of God." – is embodied by the employees, physicians and volunteers throughout SSM Health Care-St. Louis. Winners of the 2010 St. Louis Business Journal's Best Places to Work award, Modern Healthcare magazine's 2010 Best Places to Work in Healthcare award, and the 2010 Missouri Quality Award, SSM Health Care-St. Louis provides comprehensive health care services, and specializes in heart, cancer, neurosciences, pediatrics, orthopedics, maternity, weight-loss, sleep, imaging, behavioral health, and fetal surgery. Our locations include SSM Cardinal Glennon Children's Medical Center, SSM DePaul Health Center, SSM St. Clare Health Center, SSM St. Joseph Health Center, SSM St. Joseph Health Center-Wentzville, SSM St. Joseph Hospital West, SSM St. Mary's Health Center, and the offices of the SSM Medical Groups. Go to ssmhealth.com for more information.

SOURCE Anthem Blue Cross and Blue Shield in Missouri