Helping Patients Find Cost-Effective Knee/Hip Replacements

May 15, 2019

Premium Care Without Breaking the Bank

A surprising number of younger Americans are choosing to have knee and hip replacement procedures. But they might be shelling out more cash - between 30 to 40 percent more - than they really need to.

Those are just two of the unexpected findings from a new report by the Blue Cross Blue Shield Association (BCBSA). The data show that 242,000 Americans spent $25 million replacing their worn-out or damaged joints during 2017. Those under 65 are the primary market.

The report entitled "Planned Knee and Hip Replacement Surgeries Are on the Rise in the U.S.," describes a growing national market for shiny new hips and knees.

Interestingly, the exact same procedures cost 30 to 40 percent less in outpatient settings than inpatient venues. Yet only 11 percent of knee replacements happened in outpatient locations during 2017. Hip replacements were even lower at 8 percent.

  • An inpatient knee replacement costs around $30,249, while an outpatient procedure runs about $19,002.
  • An inpatient hip replacement costs $30,685, compared to $22,078 at an outpatient setting.

It’s also worth noting that prices can vary dramatically, even in the same city. In Dallas, for example, some hip replacement patients paid nearly four times the lowest price available.

Why are prospective patients missing out on these big savings? Given today’s health care complexities, they simply might not know where to look. That’s where you come in. They trust their providers to help them make informed, well-educated choices. And that’s where Blue Cross Blue Shield of Texas (BCBSTX) comes in. We can help you direct your patients to affordable, high-quality care designed to meet their needs.

Patient safety, of course, dictates where these procedures should best take place. But the report notes that safety is comparable in both inpatient and outpatient settings. In some instances, outpatient complication rates are actually lower than inpatient.

So how can BCBSTX and providers help guide patients to the best solution for their individual needs? You can start by steering them to Blue Distinction Centers+®. It’s an elite distinction awarded to health care facilities for high-quality, cost-efficient specialty care. Savings can be as high as 24 percent compared to non-Blue Distinction Centers+.

Texas has 12 Blue Distinction Centers+ specializing in knee and hip replacements.

There’s also Blue Access for MembersSM, a 24/7 online service with, among other features, cost estimates, quality rankings and patient reviews of hospitals nationwide. We’ve made it a priority to give members advanced, easy-to-use tools and options that will help them make informed decisions about the best care choices for their specific needs.

So, the next time a patient comes to you with questions about the ups and downs of hip or knee replacement, isn’t it nice to know you can give them resources and savings as well as peace of mind?

Blue Distinction Center+ designation, visit the Blue Cross Blue Shield Association website.