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Q: What is a Medicare Value-Based Care Center?

A: Value-Based Care Centers offer Medicare patients quality outcomes and the chance to share in savings. As part of a demonstration project that encourages improvements in efficiency and quality of care provided to Medicare beneficiaries, five regional health systems – including Lovelace, the only system in New Mexico participating – were designated as Value-Based Care Centers. The project is designed to support a more integrated approach to treating and paying for common orthopedic (bone and joint) problems, such as hip and knee replacements, and cardiovascular (heart) problems, such as stents and bypass surgery.

 

 

Q: How does this program work?

A: If you are covered by basic Medicare, you may qualify to receive a special incentive payment when you elect to have certain orthopedic or cardiac procedures performed at Lovelace Medical Center, Lovelace Westside Hospital and Lovelace Women’s Hospital. As part of the demonstration project, Value-Based Care Centers provide services to Medicare beneficiaries at special rates. CMS (The Centers for Medicare&Medicaid Services) will share up to 50 percent of its savings with beneficiaries in the form of incentive payments. This means that patients get to share in the savings while getting exceptional heart, bone or joint care.

 

 

 Q: As a Medicare patient, can I receive inpatient care at Lovelace Medical Center, Lovelace Westside Hospital and Lovelace Women’s Hospital if I normally use another hospital?

A: Yes.

 

 

Q: How did Lovelace Medical Center, Lovelace Westside Hospital and Lovelace Women’s Hospital receive this special designation?

A: Participating hospitals were selected based on many factors, including experience performing the covered procedures, outcomes and ongoing quality improvement efforts. In addition to providing select services at discounted rates, Value-Based Care Centers were also required to demonstrate a commitment to improving efficiency and delivering patient-centered, coordinated care.

 

Q: What are the qualifying procedures?

 

Orthopedic

A: There are nine orthopedic inpatient surgical services and procedures included in the demonstration.
Some of the included procedures are:

 

  • Hip total joint replacements
  • Knee total joint replacements
  • Revisions of hip and knee total joint replacements

 

Cardiovascular

There are 28 cardiac inpatient surgical services and procedures included in the demonstration.
Some of the included procedures are:

 

  • Cardiac valve replacement (with and without catheterization)
  • Defibrillator implantation (with and without catheterization)
  • Coronary bypass surgery (with and without catheterization)
  • Permanent pacemaker implantation
  • Pacemaker replacement and revisions
  • Balloon angioplasty (with and without drug-eluting stent placement)

 

Q: How soon after the procedure will I receive my incentive payment?

A: You should receive your check approximately three months after your procedure.

 

Q: How much will I receive?

  • Orthopedic procedures: $121-$572 per procedure.
  • Cardiac procedures: $160-$993 per procedure.

(Patient can only receive up to $1,199 annually.)

 

Q: Are other hospitals in New Mexico participating in this program?

A: No. Lovelace Medical Center, Lovelace Westside Hospital and Lovelace Women’s Hospital are the only hospitals in New Mexico offering this unique program to Medicare beneficiaries.

 

For your free information kit and to sign up for one of our upcoming seminars, call 505.727.5550.

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