Saving are achieved with pre-negotiated case rate pricing
- Claims thru BridgeHealth include all hospital, professional, rehab, and DME required during the “episode of care” for the procedure
- Participating providers see an opportunity to gain access to new patients outside their local market.
The savings realized through pre-negotiated case pricing allows enhanced plan provisions for the Plan Member such as:
- Covering all medical costs, without deductibles, co-pays or coinsurance
- Covering all travel expenses
- Allowing a companion to travel with the patient
| Procedure | Paid Costs | BridgeHealth Case Rates |
|---|---|---|
| After PPO Discounts | Including Admin Fees | |
| Heart/Vascular | ||
| CABG w/o cath | $65,000 – $80,000 | $36,000 – $43,000 |
| CABG w/cath w/comp | $80,000 – $110,000 | $55,000 – $63,000 |
| Orthopedic | ||
| Hip Arthroplasty | $45,000 – $50,000 | $22,000 – $27,000 |
| Knee Arthroplasty | $43,000 – $50,000 | $21,000 – $25,000 |
| Bilateral Knee Arthroplasty | $65,000 – $80,000 | $36,000 – $38,000 |
| Shoulder Arthroplasty | $40,000 – $50,000 | $22,000 – $27,000 |
| ACL Repair | $20,000 – $25,000 | $12,000 – $16,000 |
| Spine | ||
| Cervical Spinal Fusion | $65,000 – $90,000 | $28,000 – $36,000 |
| Lumbar Spinal Fusion | $90,000 – $120,000 | $48,000 – $57,000 |
