Care management programs come in all shapes and sizes, and UPMC Pinnacle has taken different approaches with employers to meet their needs.
The CARES program worked closely with local employers, as well as an orthopaedic practice and a third-party data analytics firm, to pilot a bundled payment program for joint replacements. Bundled payments are an alternative pricing arrangement where the price for all services related to an episode of care are fixed. The employer's goals were to improve clinical outcomes and patient satisfaction, control total costs and implement process improvements. In addition to meeting these goals, UPMC Pinnacle confirmed its role as the high-quality, low-cost provider in Central Pennsylvania. It is using the lessons learned from the pilot and has expanded the program to other parties and across other services.
UPMC Pinnacle has a long-term relationship with an employer to offer primary care to its employees at the worksite. To get the most value for every dollar they spend on health care, other organizations are also considering worksite clinics staffed by UPMC Pinnacle to:
Employers want their employees to get the right care in the right place at the right cost. Sometimes this means getting care at a UPMC Pinnacle clinic in a local grocery store.
At CARES, we understand that your employees are confused about, and frustrated with, the cost of health care, and you want them to make cost-effective decisions. So UPMC Pinnacle developed a medical cost calculator ("E$timator") to help its patients estimate out-of-pocket costs, plan for their medical expenses and make more informed decisions.
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